Echoes of Inequity: Charting Colombia's stroke mortality shifts and socioeconomic and spatial disparities over two decades

Abstract

Background

Stroke remains a significant public health challenge globally and in Colombia, influenced by socioeconomic and demographic factors. Despite declining mortality rates, inequities persist. This study explores trends in stroke mortality in Colombia (1999–2017), focusing on inequalities by age, sex, and educational attainment.

Method

A descriptive longitudinal retrospective study was conducted using mortality data from the National Administrative Department of Statistics. Standardized Mortality Rates (SMRs) were calculated, adjusting for age and sex. Poisson regression models and the Relative Index of Inequality (RII) assessed inequalities. Geographic analyses examined spatial mortality patterns using Geographic Information Systems.

Results

Between 1999 and 2017, 262,350 stroke deaths occurred, predominantly in older adults and individuals with lower educational attainment. Stroke mortality declined over time but remained higher among men (66.01/100,000) compared to women (65.74/100,000). Mortality rates were highest in individuals with primary education and lowest in those with tertiary education. Geographic analysis revealed higher mortality in more economically developed regions, suggesting potential underreporting in less developed areas. The RII highlighted pronounced inequalities, especially among women and younger age groups.

Conclusions

While stroke mortality in Colombia has decreased, marked inequities persist, particularly by educational level and geographic region. Addressing these inequalities requires targeted public health policies to enhance healthcare access and promote equity.