Life expectancy and mortality in 363 cities of Latin America

the SALURBAL group

Research output: Contribution to journalArticlepeer-review


The concept of a so-called urban advantage in health ignores the possibility of heterogeneity in health outcomes across cities. Using a harmonized dataset from the SALURBAL project, we describe variability and predictors of life expectancy and proportionate mortality in 363 cities across nine Latin American countries. Life expectancy differed substantially across cities within the same country. Cause-specific mortality also varied across cities, with some causes of death (unintentional and violent injuries and deaths) showing large variation within countries, whereas other causes of death (communicable, maternal, neonatal and nutritional, cancer, cardiovascular disease and other noncommunicable diseases) varied substantially between countries. In multivariable mixed models, higher levels of education, water access and sanitation and less overcrowding were associated with longer life expectancy, a relatively lower proportion of communicable, maternal, neonatal and nutritional deaths and a higher proportion of deaths from cancer, cardiovascular disease and other noncommunicable diseases. These results highlight considerable heterogeneity in life expectancy and causes of death across cities of Latin America, revealing modifiable factors that could be amenable to urban policies aimed toward improving urban health in Latin America and more generally in other urban environments.

Original languageEnglish
Pages (from-to)463-470
Number of pages8
JournalNature Medicine
Issue number3
StatePublished - 1 Mar 2021
Externally publishedYes

Bibliographical note

Funding Information:
We acknowledge the help of A. Peralta in discussing some of the methods. SALURBAL acknowledges the contributions of many different agencies in generating, processing, facilitating access to data or assisting with other aspects of the project. A comprehensive list of these agencies can be found here: data-acknowledgements. The SALURBAL/Urban Health in Latin America project is funded by the Wellcome Trust (205177/Z/16/Z). U.B. was also supported by the Office of the Director of the National Institutes of Health under award number DP5OD26429. The funding sources had no role in the analysis, writing or decision to submit the manuscript.

Publisher Copyright:
© 2021, The Author(s).

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology


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