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

JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE(2023)

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摘要
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.
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关键词
Life expectancy,Small area estimation,Urban health,Latin America
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