TY - JOUR
T1 - Life expectancy and mortality in 363 cities of Latin America
AU - the SALURBAL group
AU - Bilal, Usama
AU - Hessel, Philipp
AU - Perez-Ferrer, Carolina
AU - Michael, Yvonne L.
AU - Alfaro, Tania
AU - Tenorio-Mucha, Janeth
AU - Friche, Amelia A.L.
AU - Pina, Maria Fatima
AU - Vives, Alejandra
AU - Quick, Harrison
AU - Alazraqui, Marcio
AU - Rodriguez, Daniel A.
AU - Miranda, J. Jaime
AU - Diez-Roux, Ana V.
AU - Alazraqui, Marcio
AU - Spinelli, Hugo
AU - Guevel, Carlos
AU - Di Cecco, Vanessa
AU - Tisnés, Adela
AU - Leveau, Carlos
AU - Santoro, Adrián
AU - Herkovits, Damián
AU - Trotta, Andrés
AU - Aguirre, Patricia
AU - López, Santiago Rodríguez
AU - Tumas, Natalia
AU - Gouveia, Nelson
AU - Mascolli, Maria Antonietta
AU - Slovic, Anne Dorothée
AU - Martins, Lucas Soriano
AU - Kanai, Cláudio Makoto
AU - Barreto, Mauricio
AU - Santos, Gervásio
AU - de Freitas, Anderson Dias
AU - De Castro, Caio Porto
AU - Filho, José Firmino de Sousa
AU - Bell, Maria Izabel dos Santos
AU - Andrade, Roberto Fernandes Silva
AU - Cardoso, Leticia
AU - Menezes, Mariana Carvalho de
AU - Pina, Maria de Fatima de
AU - Skaba, Daniel Albert
AU - Guimarães, Joanna Miguez Nery
AU - Matos, Vanderlei Pascoal de
AU - Caiaffa, Waleska Teixeira
AU - Friche, Amélia Augusta de Lima
AU - Andrade, Amanda Cristina de Souza
AU - Vaz, Camila Teixeira
AU - Coelho, Débora Moraes
AU - Moran, Mika
N1 - 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: https://drexel.edu/lac/data-evidence/ 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).
PY - 2021/3/1
Y1 - 2021/3/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85099945586&partnerID=8YFLogxK
U2 - 10.1038/s41591-020-01214-4
DO - 10.1038/s41591-020-01214-4
M3 - Article
C2 - 33495602
AN - SCOPUS:85099945586
SN - 1078-8956
VL - 27
SP - 463
EP - 470
JO - Nature Medicine
JF - Nature Medicine
IS - 3
ER -