RESUMO
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.
Assuntos
Expectativa de Vida , Humanos , Cidades/epidemiologia , Argentina/epidemiologia , Masculino , Feminino , Fatores Socioeconômicos , Fatores Etários , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Fatores Sexuais , MortalidadeRESUMO
En el presente artículo analizamos la distancia entre el plan de salud vigente en la provincia de Río Negro, Argentina, el marco de oportunidades y recursos que brinda el Estado y las actividades de cuidado que se llevan a cabo en un Centro de Salud ubicado en la ciudad de San Carlos de Bariloche desde un enfoque de derechos. Ponemos en diálogo el plan de salud provincial con las percepciones del personal de dicho centro surgidas de entrevistas en profundidad, observaciones y grupos focales, analizando indicadores de estructura y de proceso.(AU)
In this paper we analyze the distance between the actual health plan of Rio Negro province, Argentina, the framework of opportunities and resources provided by the State, and care activities carried out in a Health Center in the city of San Carlos de Bariloche from a rights-based approach. We established a dialogue between the provincial health plan and the perceptions of the center's staff that emerged from in-depth interviews, observations and focus groups, analyzing indicators of structure and process.(AU)
Neste artigo analisamos a distância entre o plano de saúde atual, na província de Rio Negro, Argentina, o quadro de oportunidades e recursos fornecidos pelas atividades do Estado e os cuidados realizados em um Centro de Saúde localizado no San Carlos de Bariloche a partir de uma perspectiva de direitos. Estabelecemos um diálogo entre o plano de saúde do Centro da província e as percepções da equipe do referido Centro, que emergiram de entrevistas em profundidade, observações e grupos focais, analisando indicadores de estrutura e processo.(AU)