Economic fluctuations and educational inequalities in premature ischemic heart disease mortality in Argentina

CARLOS M. LEVEAU; MUSTAFA HUSSEIN; JOSÉ TAPIA GRANADOS; GUILLERMO VELÁZQUEZ

CADERNOS DE SAúDE PúBLICA

CADERNOS SAUDE PUBLICA

Lugar: Rio de Janeiro; Año: 2023 vol. 39 p. 1 - 13

0102-311X

Although mortality from ischemic heart disease (IHD) has declined over the past decades in Argentina, IHD remains one of the most frequent causes of death. The objectives of this study were to describe the role of individual and contextual factors on premature IHD mortality; and to analyze how educational differentials in premature IHD mortality changed during economic fluctuations in two provinces of Argentina during the period 1990-2018. To test the relationship between individual (age, gender, and educational level) and contextual (urbanization, poverty, and macroeconomic variations) factors, a multilevel Poisson model was estimated. Controlling for the level of poverty at the departmental level, inequalities were observed in premature IHD mortality according to the educational level of individuals, affecting population of low educational level; economic expansion was related to an increase in mortality from IHD; however, expansion years did not increased educational inequalities in IHD mortality. At the departmental level, we did not detect a contextual influence of area socioeconomic level on the risk of IHD mortality. Despite the continuing decline in mortality from IHD in Argentina, this study highlights that social inequalities in mortality risk increased over time. Therefore, prevention policies should be more focused on populations of lower socioeconomic status in Argentina.