Cardona Dora, Cerezo María Del Pilar, Parra Hernán, Quintero Liliana, Muñoz Liliana, Cifuentes Olga Lucía, Vélez Silvia Clemencia
Grupo de Investigación en Salud Pública, Universidad Autónoma de Manizales, Manizales, Colombia.
Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Colombia, Manizales, Colombia.
Biomedica. 2015 Jul-Sep;35(3):379-794. doi: 10.7705/biomedica.v35i3.2588.
The impact of mortality from cardiovascular diseases requires the measurement of the relationship between the local socioeconomic conditions and these death causes.
To determine the inequality in mortality from cardiovascular diseases in the municipalities of the Colombian Coffee Growing Region (2009-2011).
We conducted an ecological study to compare the mortality from cardiovascular diseases (hypertensive, ischemic, cerebrovascular) in municipalities and their economic situation. Mortality rates and the index of unsatisfied basic needs were obtained from the Colombian Departamento Administrativo Nacional de Estadística (DANE) vital statistics, while the municipal gross domestic product per capita was estimated for this study. The inequality indices were calculated using regression models, and concentration and Theil indices with Epidat 3.1.
The death risk resulting from ischemic or hypertensive diseases was greater in those municipalities with a higher index of unsatisfied basic needs. Mortality due to hypertensive disease tended to concentrate in municipalities with a higher level of unsatisfied basic needs. The municipalities with a lower gross domestic product showed a higher rate of deaths due to hypertensive disease in years 2009 and 2010, and due to ischemic disease in years 2010 and 2011. Nevertheless, this indicator does not measure the gap existing among poor communities.
Disaggregated inequality indicators at municipal level are lacking. Suggested indicators are estimated only for country and provincial levels and they do not favor the characterization of health social inequalities at territorial level.
心血管疾病死亡率的影响需要衡量当地社会经济状况与这些死亡原因之间的关系。
确定哥伦比亚咖啡种植区各市镇心血管疾病死亡率的不平等情况（2009 - 2011年）。
我们开展了一项生态研究，以比较各市镇心血管疾病（高血压、缺血性、脑血管性）死亡率及其经济状况。死亡率和未满足基本需求指数取自哥伦比亚国家统计局（DANE）的人口动态统计数据，而本研究估算了各市镇的人均国内生产总值。使用回归模型以及Epidat 3.1软件计算集中指数和泰尔指数，得出不平等指数。
在未满足基本需求指数较高的市镇，缺血性或高血压疾病导致的死亡风险更大。高血压疾病导致的死亡往往集中在未满足基本需求程度较高的市镇。国内生产总值较低的市镇在2009年和2010年因高血压疾病导致的死亡率较高，在2010年和2011年因缺血性疾病导致的死亡率较高。然而，该指标并未衡量贫困社区之间存在的差距。
缺乏市级层面的分类不平等指标。建议的指标仅针对国家和省级层面进行估算，不利于描述地区层面的健康社会不平等情况。
