Socio-Territorial Configuration of Mortality by Chronic Diseases of Greater Prevalence

Abstract

Chronic diseases are the leading causes of death worldwide, being the low and middle-income countries the worst affected. Only two of these mortality causes combined, cardiovascular diseases (CVD) and cancer, accounted for almost half of all deaths in Argentina in 2016. Even though it is broadly recognized that a few modifiable risk factors related to lifestyles (poor nutrition, tobacco use, lack of physical activity, and excessive use of alcohol) explain the vast majority of these diseases, there is less understanding of the socio-environmental determinants that underlie the major chronic diseases. In Argentina, the distribution of mortality rates by certain cancers or CVD within the country territory follows a social gradient and would be linked to contextual factors. This chapter examines the geographical and temporal patterns of cancer and CVD throughout the period 1996–2015, from the perspective of social inequality in health. Using different geographical scales and time cut points, we provide and interpret thematic maps about the mortality burden for these causes by sexes, which were overlapped with data about the quality of life index (QLI) by Velázquez. In the first part of the chapter, we present the spatial distribution of sex-specific mortality rates for overall cancer and CVD; we also describe mortality trends by estimating the percentage of annual change in rates between 1996 and 2015. In a second part, using spatial analysis techniques, we identified and illustrate geographical clusters of high and low values for age-standardized mortality rates (ASMR) of selected cancers or CVDs, including the most common cancer types (breast, lung, prostate, colon, cervix, and stomach cancers) and CVDs (heart failure and ischemic heart diseases) in Argentina. For ASMR estimation, databases provided by the Ministry of Health of Argentina and official census data were used. Our analysis of the geographical disparities in chronic diseases burden from the social inequality approach reinforces the need to go beyond the classical risk behaviors perspective, to assume that there are several factors—socially determined—that could underlie the unequal distribution of them in Argentina.