Latin American convergence and divergence towards the mortality profiles of developed countries

Abstract

It is uncertain whether Latin America and Caribbean (LAC) countries are approaching a single mortality regime. Over the last three decades, LAC has experienced major public health interventions and the highest number of homicides in the world. However, these interventions and homicide rates are not evenly shared across countries. This study documents trends in life expectancy and lifespan variability for 20 LAC countries, 2000-14. By extending a previous method, we decompose differences in lifespan variability between LAC and a developed world benchmark into cause-specific effects. For both sexes, dispersion of amenable diseases through the age span makes the largest contribution to the gap between LAC and the benchmark. Additionally, for males, the concentration of homicides, accidents, and suicides in mid-life further impedes mortality convergence. Great disparity exists in the region: while some countries are rapidly approaching the developed regime, others remain far behind and suffer a clear disadvantage in population health.

The adult mortality profile by cause of death in 10 Latin American countries (2000–2016)

“…Soares (2) shows that the probability of an individual dying between ages 15 and 60 years old in Latin America fell around 35% from 1960 to 2000. As Latin America moves forward in the demographic transition and the epidemiological transition, mortality declines are expected to depend less on young ages and more on adult and advanced ages (5)(6)(7)(8).…”

“…The pace of change in the mortality pattern is very heterogeneous (3,4,5,18). The diversity in behavior patterns, development levels, and technology assimilation processes among and within countries has a fundamental role in determining the decline in mortality levels, as well as the changes in the pattern of causes of death across Latin America.…”

“…On the other hand, Soares (2), Palloni and Pinto (3), and Marinho et al (4) summarize the contribution that reductions in some causes of deaths make to gains in life expectancy between 1950 and 2000, with a more considerable advance in the epidemiological transition in several Latin American and Caribbean countries. More recently, Dávila-Cervantes and Agudelo-Botero (17) have analyzed the contribution of avoidable deaths to the change in life expectancy in Argentina, Chile, Colombia, and Mexico, and Alvarez et al (5) have investigated how the changes in mortality by causes of death can impact the life-span variation in a series of Latin American and Caribbean countries. These two studies conclude that avoidable deaths continue to have a major impact on mortality, but with a great disparity among countries.…”

“…These two studies conclude that avoidable deaths continue to have a major impact on mortality, but with a great disparity among countries. In addition, Alvarez et al (5) point out that the dispersion of avoidable deaths through the age span makes the most substantial contribution to the gap between the Latin American and Caribbean countries and developed countries.…”

Lexis fields

“…The idea to draw a Lexis field arose in practice in an attempt to investigate the apparently mechanical relationship between life expectancy and lifespan variation (age-atdeath variation) with a macro view. Evidence suggests a negative relationship between these indicators when measured at young ages such as 0 or 15 (Wilmoth and Horiuchi 1999;Smits and Monden 2009;Vaupel, Zhang, and van Raalte 2011;Alvarez, Aburto, and Canudas-Romo 2019;Colchero et al 2016). This means that at the aggregate level, as life expectancy increases in low mortality countries, length of life becomes more equal, and this relationship appears to hold up generally between human populations (Colchero et al 2016).…”