The public health impact of economic fluctuations in a Latin American country: mortality and the business cycle in Colombia in the period 1980–2010

International Journal for Equity in Health

Mauricio Avendaño³  Doris Cardona⁵  Jesus Rodriguez-Garcia⁴  Alex Burdorf¹  Philipp Hessel³  Ivan Arroyave² 

[1] Department of Public Health, Erasmus University Medical Center, Dr. Molewaterplein 50, Rotterdam, GE 3015, The Netherlands;National School of Public Health, University of Antioquia, Calle 62 N° 52-59, Medellín, Colombia;Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston 02115, MA, USA;Pontificia Universidad Javeriana, Carrera 7 # 40-62, Bogotá, DC 11001000, Colombia;Faculty of Medicine, Universidad CES, Calle 10A # 22-04, Medellín, Colombia

关键词: Health insurance;    Developing countries;    Colombia;    Economic recession;    Mortality;   

Others  :  1220152
DOI  :  10.1186/s12939-015-0176-9

 received in 2014-07-07, accepted in 2015-05-15,  发布年份 2015

【 摘 要 】

Introduction

Studies in high-income countries suggest that mortality is related to economic cycles, but few studies have examined how fluctuations in the economy influence mortality in low- and middle-income countries. We exploit regional variations in gross domestic product per capita (GDPpc) over the period 1980–2010 in Colombia to examine how changes in economic output relate to adult mortality.

Methods

Data on the number of annual deaths at ages 20 years and older (n = 3,506,600) from mortality registries, disaggregated by age groups, sex and region, were linked to population counts for the period 1980–2010. We used region fixed effect models to examine whether changes in regional GDPpc were associated with changes in mortality. We carried out separate analyses for the periods 1980–1995 and 2000–2010 as well as by sex, distinguishing three age groups: 20–44 (predominantly young working adults), 45–64 (middle aged working adults), and 65+ (senior, predominantly retired individuals).

Results

The association between regional economic conditions and mortality varied by period and age groups. From 1980 to 1995, increases in GDPpc were unrelated to mortality at ages 20 to 64, but they were associated with reductions in mortality for senior men. In contrast, from 2000 to 2010, changes in GDPpc were not associated with old age mortality, while an increase in GDPpc was associated with a decline in mortality at ages 20–44 years. Analyses restricted to regions with high registration coverage yielded similar albeit less precise estimates for most sub-groups.

Conclusions

The relationship between business cycles and mortality varied by period and age in Colombia. Most notably, mortality shifted from being acyclical to being countercyclical for males aged 20–44, while it shifted from being countercyclical to being acyclical for males aged 65+.

【 授权许可】

   
2015 Arroyave et al.

【 图 表 】

Fig. 1.

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