Spatial variation of cardiovascular mortality in Cali, Colombia, between 2010 and 2017
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Author(s)
Murillo, Luisa M
Ramirez, Carolina
Andrade-Bejarano, Mercedes
Perlaza, Guillermo
Barrera Vergara, Lena
Type
Journal Article
Abstract
Background: Cardiovascular disease (CVD) is the leading cause of mortality worldwide and in Colombia. The analysis of CVD mortality has been mainly relied on individual factors and rates, but occurrence is also related to contextual conditions. Understanding the distribution of CVD in a region will contribute to implement more focused‑preventive and care interventions.
Methods: Using the national mortality register established by the Department of National Statistics, standardized rates and spatial distribution of CVD mortality were estimated for Cali, Colombia, between 2010–2017. Global and
local spatial aggregation was assessed using the Geary’s C test and for each district standardized mortality ratios smoothed by the Bayesian empirical were estimated.
Results: Over the period, CVD was the main cause of mortality with 28,804 deaths accounting for 23,8% of total deaths. The global CVD mortality rate varied from 235.9 to 257.4 per 100.000 habitants, with an average increase of 9.1% in the percentage change. The main cause of mortality were hypertensive diseases following by ischemic heart diseases and stroke. The standardized mortality ratios smoothed by the Bayesian empirical method showed that the districts 7, 13, 14, 15 and 16 located at the eastern area with the lowest socio‑economic strata and the district 22 at the south of the
city with the highest socio‑economic strata had the high risks of CVD mortality. All these areas were at the boundary of the city. The the lowest risk was observed in districts 1 and 2 at the northwest area with the upper socio‑economic strata. Over the study period, a spatial autocorrelation was found in the districts 1,9 10, 11, 12, 13, 14, 15, 19, and 21 by using the Geary’s C test. The highest significant spatial association was found in the districts 1 and 21.
Conclusion: Of 22 districts in Cali, the highest risk of CVD mortality was found in three at the lowest and one in the upper socio‑economic strata between 2013 and 2017. Over the period a global spatial aggregation was identified due mainly to districts peripherical located suggesting that there could be contextual conditions influencing the risk. Therefore, there is a need for considering local conditions to prevent CVD mortality.
Methods: Using the national mortality register established by the Department of National Statistics, standardized rates and spatial distribution of CVD mortality were estimated for Cali, Colombia, between 2010–2017. Global and
local spatial aggregation was assessed using the Geary’s C test and for each district standardized mortality ratios smoothed by the Bayesian empirical were estimated.
Results: Over the period, CVD was the main cause of mortality with 28,804 deaths accounting for 23,8% of total deaths. The global CVD mortality rate varied from 235.9 to 257.4 per 100.000 habitants, with an average increase of 9.1% in the percentage change. The main cause of mortality were hypertensive diseases following by ischemic heart diseases and stroke. The standardized mortality ratios smoothed by the Bayesian empirical method showed that the districts 7, 13, 14, 15 and 16 located at the eastern area with the lowest socio‑economic strata and the district 22 at the south of the
city with the highest socio‑economic strata had the high risks of CVD mortality. All these areas were at the boundary of the city. The the lowest risk was observed in districts 1 and 2 at the northwest area with the upper socio‑economic strata. Over the study period, a spatial autocorrelation was found in the districts 1,9 10, 11, 12, 13, 14, 15, 19, and 21 by using the Geary’s C test. The highest significant spatial association was found in the districts 1 and 21.
Conclusion: Of 22 districts in Cali, the highest risk of CVD mortality was found in three at the lowest and one in the upper socio‑economic strata between 2013 and 2017. Over the period a global spatial aggregation was identified due mainly to districts peripherical located suggesting that there could be contextual conditions influencing the risk. Therefore, there is a need for considering local conditions to prevent CVD mortality.
Date Issued
2023-03-31
Date Acceptance
2022-12-20
Citation
BMC Public Health, 2023, 23, pp.1-10
ISSN
1471-2458
Publisher
BioMed Central
Start Page
1
End Page
10
Journal / Book Title
BMC Public Health
Volume
23
Copyright Statement
© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
License URL
Identifier
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14907-x
Publication Status
Published
Article Number
616
Date Publish Online
2023-03-31