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Gutiérrez-Lesmes O, Grisales-Romero H. Burden of disease in Colombian Orinoquia Region, 2017. F1000Res 2023; 11:1257. [PMID: 39205865 PMCID: PMC11350327 DOI: 10.12688/f1000research.124503.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 09/04/2024] Open
Abstract
Background Population health diagnoses are a fundamental tool to guide health policies and programs, and consequently, public health requirements. In this perspective, the burden of disease in inhabitants of Colombian Orinoquia is quantified for the first time. Methods A descriptive population-based study that was based on secondary sources was carried out, which aimed at measuring the burden of the disease in the Colombian region of Orinoquia, using the simplified synthetic indicator of disability-adjusted life years (DALYs) of the global health estimation methodology. We used mortality records from the National Administrative Department of Statistics (DANE) and service provision records from the Ministry of Health and Social Protection of Colombia, both records from the year 2017, available on the Integrated Social Protection Information System. Results 288,740.2 DALYs occurred (95% UI 210,714.6-382,948.8), with higher reports for men (59%); group of non-communicable diseases accounted for 62.3% of DALYs (179,993.6, 95% UI, 115,030.2-268,405.0), followed by external cause injuries group which contributed 24.6% (71,000.0, 95% UI, 25,638.1-134,013.1), and group of communicable, maternal, neonatal, and nutritional disorders which contributed 13.1% (37,746.0, 95% UI, 28,048.0-50,239.7). Interpersonal violence was the primary cause specific of DALYs with 9.8% of the burden, (28,290.0, 95% UI, 7,365.1-64,208.1). Conclusions Most DALYs in Orinoquia are produced by non-communicable diseases (NCD), largely caused by neoplasms and cardiovascular disease, which increased with age. However, when considered by specific cause of illness or injury, interpersonal violence is indicated as the main cause of DALYs, affecting mainly young men, possibly as an expression of social inequality, substance use, criminality, and insecurity. It is important to highlight that this region has been recognized as an area of armed conflict, drug trafficking, and poverty.
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Affiliation(s)
- Oscar Gutiérrez-Lesmes
- Escuela de Salud Pública, Universidad de los Llanos, Villavicencio, Meta, Colombia
- Grupo Demografía y Salud, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Hugo Grisales-Romero
- Escuela de Salud Pública, Universidad de los Llanos, Villavicencio, Meta, Colombia
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Correa-Salazar C, Braverman-Bronstein A, Bilal U, Groves AK, Page KR, Amon JJ, Vera A, Ballesteros L, Martínez-Donate A. The impact of social violence on HIV risk for women in Colombia: A concurrent mixed methods study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001571. [PMID: 36963089 PMCID: PMC10021609 DOI: 10.1371/journal.pgph.0001571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/01/2023] [Indexed: 02/26/2023]
Abstract
Gender, violence, and migration structurally impact health. The Venezuelan humanitarian crisis comprises the largest transnational migration in the history of the Americas. Colombia, a post-conflict country, is the primary recipient of Venezuelans. The Colombian context imposes high levels of violence on women across migration phases. There is little information on the relationship between violence and HIV risk in the region and how it impacts these groups. Evidence on how to approach the HIV response related to Venezuela's humanitarian crisis is lacking. Our study seeks to 1) understand how violence is associated with newly reported HIV/AIDS case rates for women in Colombian municipalities; and 2) describe how social violence impacts HIV risk, treatment, and prevention for Venezuelan migrant and refugee women undergoing transnational migration and resettlement in Colombia. We conducted a concurrent mixed-methods design. We used negative binomial models to explore associations between social violence proxied by Homicide Rates (HR) at the municipality level (n = 84). The also conducted 54 semi-structured interviews with Venezuelan migrant and refugee women and key informants in two Colombian cities to expand and describe contextual vulnerabilities to HIV risk, prevention and care related to violence. We found that newly reported HIV cases in women were 25% higher for every increase of 18 homicides per 100,000, after adjusting for covariates. Upon resettlement, participants cited armed actors' control, lack of government accountability, gender-based violence and stigmatization of HIV as sources of increased HIV risk for VMRW. These factors impose barriers to testing, treatment and care. Social violence in Colombian municipalities is associated with an increase in newly reported HIV/AIDS case rates in women. Violence hinders Venezuelan migrant and refugee women's access and engagement in available HIV prevention and treatment interventions.
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Affiliation(s)
- Catalina Correa-Salazar
- Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Ariela Braverman-Bronstein
- Epidemiology and Biostatistics Department, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Usama Bilal
- Epidemiology and Biostatistics Department, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Ali K. Groves
- Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Kathleen R. Page
- Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Joseph J. Amon
- Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Alejandra Vera
- Corporación Mujer Denuncia y Muévete NGO, Cúcuta, Colombia
| | | | - Ana Martínez-Donate
- Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, United States of America
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Braverman-Bronstein A, Vidaña-Pérez D, Ortigoza AF, Baldovino-Chiquillo L, Diez-Canseco F, Maslowsky J, Sánchez BN, Barrientos-Gutiérrez T, Diez Roux AV. Adolescent birth rates and the urban social environment in 363 Latin American cities. BMJ Glob Health 2022; 7:bmjgh-2022-009737. [PMID: 36253017 PMCID: PMC9577896 DOI: 10.1136/bmjgh-2022-009737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/06/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Latin America has the second-highest adolescent birth rate (ABR) worldwide. Variation between urban and rural areas and evidence linking country development to ABR points towards upstream factors in the causal pathway. We investigated variation in ABR within and between cities, and whether different features of urban social environments are associated with ABR. Methods We included 363 cities in 9 Latin American countries. We collected data on social environment at country, city and subcity levels and birth rates among adolescents (ages 15–19). We investigated variation in ABR within and between countries and cities along with associations between social environment and ABR by fitting three-level negative binomial models (subcities nested within cities nested within countries). Results The median subcity ABR was 58.5 per 1000 women 15–19 (IQR 43.0–75.3). We found significant variability in subcity ABR between countries and cities (37% of variance between countries and 47% between cities within countries). Higher homicide rates and greater population growth in cities were associated with higher ABR (rate ratio (RR) 1.09; 95% CI 1.06 to 1.12 and RR 1.02; 95% CI 1.00 to 1.04, per SD, respectively), while better living conditions and educational attainment in subcities were associated with lower ABR after accounting for other social environment characteristics (RR 0.95; 95% CI 0.92 to 0.98 and 0.78; 95% CI 0.76 to 0.79, per SD, respectively). Conclusions The large heterogeneity of ABR found within countries and cities highlights the key role urban areas have in developing local policies. Holistic interventions targeting education inequalities and living conditions are likely important to reducing ABR in cities.
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Affiliation(s)
- Ariela Braverman-Bronstein
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Dèsirée Vidaña-Pérez
- Center for Survey Research and Evaluation, National Institute of Public Health, Cuernavaca, Mexico
| | - Ana F Ortigoza
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Julie Maslowsky
- Center of Excellence in Maternal and Child Health School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Brisa N. Sánchez
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Ana V. Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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Dávila-Cervantes CA, Pardo-Montaño AM. The burden of injuries in Mexico: Secondary data analysis from the Global Burden of Disease Study, 1990 to 2019. Injury 2021; 52:467-477. [PMID: 33612252 DOI: 10.1016/j.injury.2021.02.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/25/2021] [Accepted: 02/12/2021] [Indexed: 02/08/2023]
Abstract
IMPORTANCE Injuries have been a major cause of premature mortality and short-term and long-term disability in Mexico. OBJECTIVE To report the findings from the Global Burden of Disease 2019 study on injuries in Mexico at a national and subnational scale from 1990 to 2019. METHODS Following the 2019 Global Burden of Disease study we examined injury mortality, premature mortality, years lived with disability and disability-adjusted life-years according to 14 subcategories. We calculated the Pearson correlation coefficient between the injury burden and the socio-demographic index. RESULTS While the number of deaths from injuries increased significantly, the changes in the age-standardized mortality rates trended towards declines. Interpersonal violence, road injuries, falls and self-harm accounted for 8 of every 10 deaths from injury in 2019. Injury mortality and the disability-adjusted life-years rates decreased nationally and in most states in the period as a whole, but have increased since 2007. The injury burden was higher for men in all age groups. Interpersonal violence caused the highest disability-adjusted life-years rate in males and road injuries in females. The socio-demographic index increased in all states, while the injury age-standardized disability-adjusted life-years rates between 1990 and 2019 decreased, but there was no statistical association between both indicators. DISCUSSION AND CONCLUSIONS This study represents a comprehensive review of injury burden of disease in Mexico. The injury burden decreased, but improved heterogeneously among states. To further reduce the injury burden of disease, it's necessary for federal, state and local governments to prioritize safety promotion and injury prevention programs, infrastructure improvements, legislation, and enforcement at a national and subnational level. Mexico's injury prevention efforts should also be tailored for specific age groups, such as males aged 20-49 years or females in the younger and older age groups, and high-burden areas.
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Affiliation(s)
- Claudio Alberto Dávila-Cervantes
- Latin American Faculty of Social Sciences Mexico. Carretera al Ajusco 377, Colonia Héroes de Padierna, Tlalpan, Mexico City, Mexico. 14200
| | - Ana Melisa Pardo-Montaño
- Institute of Geography, UNAM. Circuito de la Investigación Científica, Ciudad Universitaria, C.U., Coyoacán, Mexico City, Mexico. 04510.
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Aburto JM, Calazans J, Lanza Queiroz B, Luhar S, Canudas-Romo V. Uneven state distribution of homicides in Brazil and their effect on life expectancy, 2000-2015: a cross-sectional mortality study. BMJ Open 2021; 11:e044706. [PMID: 33589464 PMCID: PMC7887357 DOI: 10.1136/bmjopen-2020-044706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/08/2021] [Accepted: 01/28/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine cause-specific and age-specific contributions to life expectancy changes between 2000 and 2015, separately by state and sex in Brazil, with a focus on homicides. DESIGN Retrospective cross-sectional demographic analysis of mortality. SETTING AND POPULATION Brazilian population by age, sex and state from 2000 to 2015. MAIN OUTCOME MEASURE Using mortality data from the Brazilian Mortality Information System and population estimates from the National Statistics Office, we used death distribution methods and the linear integral decomposition model to estimate levels and changes in life expectancy. We also examine how multiple causes of death, including those attributable to homicides and amenable/avoidable mortality, contributed to these changes from 2000 to 2015. RESULTS Between 2000 and 2015, life expectancy in Brazil increased from 71.5 to 75.1 years. Despite state-level variation in gains, life expectancy increased in almost all states over this period. However across Brazil, homicide mortality contributed, to varying degrees, to either attenuated or decreased male life expectancy gains. In Alagoas in 2000-2007 and Sergipe in 2007-2015, homicides contributed to a reduction in life expectancy of 1.5 years, offsetting gains achieved through improvements due to medically amenable causes. In the period 2007-2015, male life expectancy could have been improved by more than half a year in 12 of Brazil's states if homicide mortality had remained at the levels of 2007. CONCLUSIONS Homicide mortality appears to offset life expectancy gains made through recent improvements to mortality amenable to medical services and public health interventions, with considerable subnational heterogeneity in the extent of this phenomenon. Efforts combating the causes of homicides can increase life expectancy beyond what has been achieved in recent decades.
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Affiliation(s)
- José Manuel Aburto
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Julia Calazans
- CEDEPLAR, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Shammi Luhar
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Vladimir Canudas-Romo
- School of Demography, Australian National University, Canberra, Australian Capital Territory, Australia
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Abstract
The aim of this research is to analyse the effect of income inequality on the homicide rate. The study is carried out in 18 Latin American countries for the period 2005–2018. The methodology used is the Generalized Least Squares (GLS) model and the data were obtained from World Development Indicators, the World Health Organization and the Inter-American Development Bank. Thus, the dependent variable is the homicide rate and the independent variable is income inequality. In addition, some control variables are included, such as: poverty, urban population rate, unemployment, schooling rate, spending on security and GDP per capita, which improve the consistency of the model. The results obtained through GLS model determine that inequality has a negative and significant effect on the homicide rate for high-income countries (HIC) and lower-middle-income countries (LMIC), whereas it is positive and significant for upper-middle-income countries (UMIC). On the other hand, the control variables show different results by group of countries. In the case of unemployment, it is not significant in any group of countries. Negative spatial dependence was found regarding spatial models such as: the spatial lag (SAR) and spatial error (SEM) method. In the spatial Durbin model (SDM), positive spatial dependence between the variables was corroborated. However, spatial auto-regressive moving average (SARMA) identified no spatial dependence. Under these results it is proposed: to improve productivity, education and improve the efficiency of security-oriented resources.
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Dávila-Cervantes CA, Agudelo-Botero M, Gómez-Dantés H. Trends and differences in homicide mortality in Colombia and Mexico, 1990-2016: Two Realities, One Problem. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 36:7962-7977. [PMID: 31072172 DOI: 10.1177/0886260519847775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Colombia and Mexico are among the countries in the region with the highest rates of homicide mortality and are also the drug traffickers in the world. The objective of this study was to analyze the trends and differences in homicide mortality in Colombia and Mexico between 1990 and 2016. Using data from the Global Burden of Disease Study, we report mortality rates and trends in years of life lost to homicides. This study looked at injuries occurring because of interpersonal violence, which was divided into three types (firearm, sharp object, and others). The homicide mortality rate steadily decreased since 1992 in Colombia, while in Mexico, it varied over time. This rate in Colombia has not been reduced to Mexico's level, and in turn, Mexico has not had a mortality rate as high as Colombia's. Throughout the period, in both countries, the years of life lost rate decreased (52% in Colombia and 18.6% in Mexico); however, between 2002 and 2016, the years of life lost rate from homicides was reduced in all age groups in Colombia, and in Mexico, they increased notably, mainly between 15 and 54 years of age. Public health plays a central role in abating interpersonal violence through the prevention of risk factors, and through making information available so that decision-makers can create public policies using evidence-based arguments. The Global Burden of Disease Study is a crucial resource that can be used to define, describe, and evaluate the consequences of homicides and help direct efforts and resources to the most vulnerable groups.
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Affiliation(s)
| | - Marcela Agudelo-Botero
- National Autonomous University of Mexico, School of Medicine, Politics, Population and Health Research Center, Mexico City, Mexico
| | - Héctor Gómez-Dantés
- National Institute of Public Health, Health Systems Research Center, Cuernavaca, Mexico
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