Citation

Arroyave I, Burdorf A, Cardona D, Avendano M. Prev. Med. 2014; 64: 41-47.

Affiliation

Department of Public Health, Erasmus University Medical Center, Dr. Molewaterplein 50, 3015 GE, Rotterdam, The Netherlands; Faculty of Medicine, Universidad CES, Calle 10A # 22-04, Medellin, Colombia; London School of Economics and Political Science, LSE health and Social Care, Cowdray House, Houghton Street - London WC2A 2AE, UK; Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. Electronic address: M.Avendano-Pabon@lse.ac.uk.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.ypmed.2014.03.018

PMID

24674854

Abstract

OBJECTIVES: Non-communicable diseases have become the leading cause of death in middle-income countries, but mortality from injuries and infections remains high. We examined the contribution of specific causes to disparities in adult premature mortality (ages 25-64) by educational level from 1998 to 2007 in Colombia.

METHODS: Data from mortality registries were linked to population censuses to obtain mortality rates by educational attainment. We used Poisson regression to model trends in mortality by educational attainment and estimated the contribution of specific causes to the Slope Index of Inequality.

RESULTS: Men and women with only primary education had higher premature mortality than men and women with post-secondary education (RRmen=2·60, 95% confidence interval [CI]:2·56, 2·64; RRwomen=2·36, CI:2·31, 2·42). Mortality declined in all educational groups, but declines were significantly larger for higher-educated men and women. Homicide explained 55·1% of male inequalities while non-communicable diseases explained 62·5% of female inequalities and 27·1% of male inequalities. Infections explained a small proportion of inequalities in mortality.

CONCLUSION: Injuries and non-communicable diseases contribute considerably to disparities in premature mortality in Colombia. Multi-sector policies to reduce both interpersonal violence and non-communicable disease risk factors are required to curb mortality disparities.

Language: en