Socio-economic Disparities in Adult Mortality in Latin America*

Abstract

Introduction Large socioeconomic disparities in health care utilization and health outcomes have been well-documented in Latin American countries. However, little is known about disparities in mortality rates. We estimate socioeconomic gradients in mortality in the Latin American region and discuss their patterns. Methods We utilize death certificate data from the national vital statistics systems and population data from national censuses in Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, and Peru (2010-2019) to calculate mortality rates by age, sex, and educational attainment. We also calculate mortality rates by cause of death. Data are harmonized to ensure comparability across countries and between death certificates and census data within countries. To analyze socioeconomic disparities, we compute the ratio between the mortality rate for individuals with a lower level of education (secondary incomplete or less) and the mortality rate for individuals with a higher level of education (secondary complete or more) by age and sex. The socioeconomic analysis is limited to adults aged 20 years or older. Results Mortality rates for individuals with lower education are higher at all age groups than for individuals with higher education, with larger disparities observed in younger age groups. Differences across countries in these inequalities are also more pronounced in younger cohorts. In the 20-69 age range, highly educated groups show similar mortality rates across countries, with most differences occurring in lower education groups. Lower education is associated with higher mortality rates from violent causes, particularly before age 50. Among non-violent causes, infectious diseases exhibit larger socioeconomic gradients than non-communicable diseases. Amongst the latter, deaths from diabetes and cardiovascular diseases exhibit more socioeconomic inequality than those from neoplasms. Conclusion Despite overall improvements in average health indicators in the region, which are concomitant to a fall in income inequality and expansion of universal health coverage, significant challenges remain in addressing disparities in mortality rates, particularly for younger populations and women.