Spatial Inequities in Life Expectancy in Small Areas of Buenos Aires, Argentina 2015–2017

Abstract

Studies of life expectancy (LE) in small areas of cities are relatively common in high-income countries but rare in Latin American countries. Small-area estimation methods can help to describe and quantify inequities in LE between neighborhoods and their predictors. Our objective was to analyze the distribution and spatial patterning of LE across small areas of Ciudad Autónoma de Buenos Aires (CABA), Argentina, and its association with socioeconomic characteristics. As part of the SALURBAL project, we used georeferenced death certificates in 2015–2017 for CABA, Argentina. We used a spatial Bayesian Poisson model using the TOPALS method to estimate age- and sex-specific mortality rates. We used life tables to estimate LE at birth. We obtained data on neighborhood socioeconomic characteristics from the 2010 census and analyzed their associations. LE at birth was higher for women (median of across neighborhoods = 81.1 years) compared to men (76.7 years). We found a gap in LE of 9.3 (women) and 14.9 years (men) between areas with the highest and the lowest LE. Better socioeconomic characteristics were associated with higher LE. For example, mean differences in LE at birth in areas with highest versus lowest values of composite SES index were 2.79 years (95% CI: 2.30 to 3.28) in women and 5.61 years (95% CI: 4.98 to 6.24) in men. We found large spatial inequities in LE across neighborhoods of a large city in Latin America, highlighting the importance of place-based policies to address this gap.

Social inequalities and COVID-19 mortality between neighborhoods of Bariloche city, Argentina

“…Deprivation-related inequalities in the mortality rate from COVID-19 showed a pattern that was similar to that observed for mortality from other causes across Latin American cities and across larger areas within cities [ 38 , 48 ]. Moreover, as in this study, area-level education for small areas was also the indicator with the strongest association with life expectancy across neighborhoods in CABA and Córdoba, two other Argentinian cities [ 32 , 33 ].…”

“…We also obtained the projected population estimates for 2018 (details in supplementary material, Appendix 1 ), the latest year for which the data was available, by age at the city level (not by neighborhood) from Dirección de Estadística y Censos for the Río Negro province [ 31 ]. Applying the age-and neighborhood-specific population proportion from the census 2010 population to the projected 2018 population, we approximated the age-and neighborhood-specific population for 2018, as done in prior studies examining small-area inequalities in mortality in other cities of Argentina [ 32 , 33 ]. Because our study window spans 2 years, we doubled the estimated 2018 population by age and neighborhood as the population denominator in calculating mortality rates.…”

“…These variables were selected since they have been associated with other outcomes in small areas in Latin American cities in previous studies [ 27 , 32 , 33 , 37 , 38 ], are good measures of area-level socio-economic status (SES), are directly linked to COVID-19 transmission [ 18 ], and are commonly available from census data at small area level. They were all retrieved from the 2010 census [ 30 ].…”