Poverty determinants of acute respiratory infections among Mapuche indigenous peoples in Chile's Ninth Region of Araucania, using GIS and spatial statistics to identify health disparities

Abstract

Background: This research concerns Araucanía, often called the Ninth Region, the poorest region of Chile where inequalities are most extreme. Araucanía hasn't enjoyed the economic success Chile achieved when the country returned to democracy in 1990. The Ninth Region also has the largest ethnic Mapuche population, located in rural areas and attached to small agricultural properties. Written and oral histories of diseases have been the most frequently used methods to explore the links between an ancestral population's perception of health conditions and their deprived environments. With census data and hospital records, it is now possible to incorporate statistical data about the links between poverty and disease among ethnic communities and compare results with non-Mapuche population.

Evolution of the nutritional situation of indigenous and non-indigenous Chilean schoolchildren

“…Among its strengths, this work stands out as being the first ever carried out in the country that attempts to study nutritional problems according to ethnic group, using the last names as an indicator, which has been previously used in indigenous populations in Chile (Rojas 2007). It also should be highlighted that for this work an identification and verification process of more than 7000 Mapuche surnames was carried out.…”

Neighborhood Socioeconomic Status and Health: A Longitudinal Analysis

“…Although many researchers have examined chronic health conditions in the context of neighborhoods [e.g., cardiovascular conditions;5], some have examined acute conditions such as respiratory infections [e.g.,6, 7]. Both acute and chronic conditions are observed more often in deprived neighborhoods.…”

Pobreza y mortalidad perinatal en la población mapuche de la Araucanía

“…Nunca antes se había establecido este vínculo quizás por la falta de información a nivel desagregado y de empalmar el micro dato territorial de modo de establecer simultá-neamente las asociaciones ente el dato a nivel individual (atributos de la persona o paciente) y el contexto socio-económico de procedencia. En una investigación anterior (Rojas 19 ) se había constatado la relación directa entre pobreza y enfermedades respiratorias agudas y mortalidad por esa misma causa para un año (2003). También la mayor incidencia de enfermedad y muerte (todas las causales de mortalidad) para la población mapuche en todas las edades se había logrado establecer con un diseño crossseccional válido para un solo momento en el tiempo.…”

“…Los métodos de aplicación para modelos generales lineares (GLM) y los modelos generales lineares mixtos (GLMM) pueden encontrarse en Rojas 19,20 , y Rojas & Suchindran 21 .…”