Large-scale societal factors and noncommunicable diseases: Urbanization, poverty and mortality spatial patterns in Argentina

Authors
Pou, Sonia Alejandra; Tumas, Natalia; Sánchez Soria, David; Ortiz, Pablo; Diaz, Maria del Pilar
Publication Year
2017
Language
English
Format
article
Status
Published version
Description
In developing countries, the rapid increase in noncommunicable diseases burden has been accompanied by socio-demographic changes, such as rapid urbanization, with persistence of considerable socio-economic gaps between populations. In Argentina, cardiovascular diseases (CVD) and cancer are leading causes of death. The aim of this study was to identify geographic clustering of mortality rates related to both diseases in Argentina and to assess their association with two large-scale societal factors, urbanization and poverty contexts. Materials and methods: We performed an ecological study in Argentina (n ¼ 525 counties), 2009e2011 period. Using spatial analysis techniques we identified and mapped spatial clusters of high and low values for age-standardized mortality rates (ASMR) of cancer or CVD and for selected urbanization and poverty indicators. We estimated incidence-rate ratios using two-level Poisson regression models, which accounted for rates distribution spatial variability. Results: Cancer and CVD mortality rates distribution were spatially dependent. Population growth showed an inverse association with ASMR from these causes, for both sexes. We detected an additive interaction of effects between urban scale and poverty level, being the “rural poverty” associated with an increasing risk of mortality by cancer (in both sexes) or by CVD (only men), compared to contexts with high urban scale and low poverty level. Counties with an intermediate urban scale seem to present the most favorable context, even when their socio-economic conditions are more unfavorable than those with higher urbanization levels. Conclusions: Geographical differences in urban and socioeconomic contextual conditions can explain spatial variation in NCD mortality burden in Argentina
Fil: Pou, Sonia Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina
Fil: Tumas, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentina
Fil: Sánchez Soria, David. Asociación Ecuatoriana de Estudios de Población; Ecuador
Fil: Ortiz, Pablo. Universidad Nacional de Córdoba. Facultad de Ciencias Económicas; Argentina
Fil: Diaz, Maria del Pilar. Universidad Nacional de Cordoba. Facultad de Medicina. Escuela de Nutricion. Cat.de Estadistica y Bioestasdística; Argentina
Subject
ARGENTINA
CANCER
CARDIOVASCULAR DISEASES
POVERTY
SPATIAL EPIDEMIOLOGY
URBANIZATION
Salud Ocupacional
Ciencias de la Salud
CIENCIAS MÉDICAS Y DE LA SALUD
Access level
Restricted access
License
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repository
CONICET Digital (CONICET)
Institution
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identifier
oai:ri.conicet.gov.ar:11336/65390