Indigenous mortality and inequalities in Latin America

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Latin America (LA) has experienced rapid improvements in life expectancy, reduced poverty, and infant mortality. Although social-economic, and health disparities between indigenous and non-indigenous remain.
Mortality information by ethnicity isn't available from most of LA countries.

The study aims to assess mortality inequalities between indigenous and non-indigenous in Brazil and Ecuador.

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Indigenous mortality and inequalities in Latin America

  1. 1. 20th Canadian Conference on Global Health Indigenous Mortality and Inequalities in Latin 27–29 October 2013 America: the cases of Brazil and Ecuador Ottawa, Canada Fatima Marinho de Souza1, Patricia Soliz1, Ramón Martinez1, Airlane Alencar2, Fabiana Del Popolo3 1 Poster Number 91 Pan American Health Organization, 2University of Sao Paulo, Brazil, 3CELADE Objective Latin America (LA) has experienced rapid improvements in life expectancy, reduced poverty, and infant mortality. Although social-economic, and health disparities between indigenous and non-indigenous remain. Mortality information by ethnicity isn’t available from most of LA countries. Outcomes • 17 of 20 LA countries encompass 47 million indigenous, 9% of the population (Table 1). There are 896,917 indigenous in Brazil (0.5% of the population) and 1,018,176 in Ecuador (7%). • In Brazil, urban areas comprise 36% of the indigenous and 85% of nonTitle indigenous. Aged 15-under 36% are indigenous and 24% are non-indigenous. Illiteracy rate is 23% in indigenous and 9% among non-indigenous in aged 15over. • In Ecuador, urban areas comprise 21% of the indigenous and 66% of nonindigenous. Aged 15-under are 37% of the indigenous and 31% of nonindigenous. Illiteracy rate is 23% among indigenous and 7% among nonindigenous in aged 15-over. The study aims to assess mortality inequalities between indigenous and non-indigenous in Brazil and Ecuador. • Under-five mortality rates in indigenous were 2.5 and 1.6 fold of nonindigenous in Brazil and Ecuador respectively. Methods • In both, first cause of death was pneumonia-influenza among indigenous, killing significantly more indigenous aged 5-under and non-indigenous aged 70-over. Census results from 2000/2010 from all LA countries’ Statistics Institutes were used to count indigenous and describing socio-demographic characteristics in Brazil and Ecuador. Brazil Ministry of Health and Ecuador National Institute of Statistics provided mortality data for 2010. • In Brazil, intestinal-infection was the third cause of death in indigenous, 6 times higher than non-indigenous and malnutrition/anemia was ranked fifth, 2.4 higher than non-indigenous (Table 2). • In Ecuador, malnutrition and anemia was ranked ninth, rate ratio of 2.4 (Table 3). In both countries, indigenous suicide rate was twice of non-indigenous, being 10 fold among indigenous aged 15-19. Table 2: Leading causes of death among indigenous and non-indigenous. Brazil 2010 Death certificates, including underlying causes of death coded using ICD-10 were used. The leading causes of death for indigenous and non-indigenous were compared; crude and age-standardized mortality rates by causes were estimated, and rate ratio calculated. Title Table 1: Indigenous Population in Latin America countries Countries and Census Year Argentina, 2010 Total Population 40,117,096 Indigenous Population 955,032 Indigenous % Bolivia 2010(a) 9,995,000 6,216,026 62.2 Brazil 2010 190,755,799 896,917 0.5 Chile 2012 1,6634,603 1,842,607 11.1 Colombia 2005 41,468,384 1,392,623 3.4 Costa Rica 2011 4,301,712 104,143 2.4 Ecuador 2010 14,483,499 1,018,176 7.0 El Salvador 2007 5,744,113 13,310 0.2 Guatemala 2010(a) 14,334,000 5,881,009 41.0 Honduras 2010(a) 7,619,000 536,541 7.0 Mexico 2010 (b) 112,336,538 19,906,326 17.7 Nicaragua 2005 4,979,850 443,847 8.9 * Rate by 100,000/people Table 3: Leading causes of death among indigenous and non-indigenous. Ecuador 2010 2.4 Panama 2010 Outcomes 3,405,813 417,559 12.3 Paraguay 2010(a) 6,458,000 110,730 1.7 Peru 2007 ( c) 27,053,394 6,489,109 24.0 Uruguay 2011 3,251,654 159,319 4.9 Venezuela, Rep. Bol. 2011 TOTAL 2,722,7930 759,960 2.8 530,166,385 47,143,233 8.9 Source: Del Popolo, Fabiana (2013); "Pueblos indígenas y afrodescendientes en los censos de la década 2010 de América Latina: avances y desafíos en el derecho a la información", CELADECEPAL, Santiago, Chile. (a) For these countries there is not census round results 2010. Therefore, the percentages of indigenous population derived from the 2000 census round was applied to the estimated total population in 2010, the latter on the basis of population estimates prepared by the CELADE (Demographic Observatory No. 11) (b) Because the question on ethnicity was applied to the population 3 years and over, Indigenous status assigned to children under 3 years old when the head of household or spouse is declared indigenous (c ) Peru included in this census only native language therefore we estimated the indigenous population with the following criteria: when the head of household or spouse declared an indigenous language, all household members were assigned as indigenous Conclusion s Title * Rate by 100,000/people Discussion and Conclusion Indigenous have social-demographic and mortality pattern of poverty: high birth and mortality rates, young population, rural residency, high illiteracy, and high infectious disease and malnutrition mortality rates. Suicide is a leading cause of death among indigenous. Studies showed that high suicide rate among young indigenous result from discrimination and living between two worlds. Inequality between indigenous and non-indigenous has existed for centuries. Indigenous are dying by avoidable causes, including high child mortality. They haven’t been benefited by social-economic and health improvements observed in LA.

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