Characterizing social inequalities in health in the Region of the Americas

ABALLAY, LAURA ROSANA; CAMILA NICLIS; SONIA ALEJANDRA POU; JULIA MARIEL WIRTZ BAKER; EUGENIA HALUSZKA; CAMILA ORMAECHEA; STEFANO STAURINI; GABRIELA DÍAZ ROUSSEAU; JULIA BECARIA COQUET

Kaohsiung, Taiwan

Conferencia; 35th Anual Conference of the International Society of Environmental Epidemiology; 2023

International Society of Environmental Epidemiology

BACKGROUND AND AIM: The Region of Americas is characterized by inequalities in demography, socioeconomic conditions, health systems and public policies that play a key role in shaping epidemiological scenarios. Therefore, we aim to study the epidemiological trends of morbidity to identify baseline socio-health scenarios of the region characterizing social inequalities in health. METHOD: A descriptive ecological study of 27 countries in the Americas was developed using the latest data from WHO, PAHO, UN Development Programme, GCO and OurWorldInData. The baseline sociohealth scenarios were identified using cluster analysis (Ward's method). The socio-demographic variables studied were the percentage of elderly population, Human Development Index (HDI), coverage of essential services, and health expenditure. Epidemiological variables included the prevalence of obesity, hypertension, and diabetes, and cancer incidence, for the 2014-2019 period. Clusters data and socio-health characteristics were mapped using a GIS.RESULTS: We identified 3 clusters representing different socio-health scenarios. The first one included the Southern countries (Chile, Brazil, Argentina, Uruguay), together with the Bahamas, Costa Rica, Cuba and Jamaica; the second cluster included North American countries (Canada and USA); and the third included 63% of the rest. Comparative analysis of socio-demographic and epidemiological characteristics between clusters showed that the second cluster has a better socio-health situation (higher average HDI and health expenditure) and an older population, with higher burdens of obesity and cancer. We observed that the first and third clusters had similar epidemiological profiles, but the first one had a higher average HDI and health expenditure, while the third had a less-aged population and the lowest average HDI.CONCLUSIONS: Most countries in the Americas region (93%) presented a very different socio-health scenario to the countries in the north of the continent, which presented a more favorable socioeconomic situation but higher burdens of obesity and cancer. Grants FONCYT-PICT-2019-04594.