A global view of population health in Colombia: role of social macro-determinants
Keywords:
social conditions, world health, health policy, social inequity, life expectancy
Abstract
Introduction. The social environment is an important determinant of population and individual health. However, its impact is often not considered in national health policies and generally its attributes are considered as constants. For this reason, contemporary health policies place greater emphasis on individual risk factors.Objective. Colombia's position in the world ranking is described with respect to several social macro-determinants of health, previously characterized as components of class/welfare regime model.
Materials and methods. The exploratory study included all countries with comparable data including the following: (1) economic development [gross domestic product per capita adjusted for purchasing power parity], (2) income inequality [Gini coefficient], (3) social capital [corruption perceptions index and generalized trust], and (4) political regime [index of freedom]. First, correlations between these macro-determinants were estimated, and second, the relationship between them and life expectancy at birth was explored. Finally, the position of Colombia in global context was determined.
Results. Important correlations occurred among the macro-determinants. Colombia tended to have intermediate to low positions in the global context in all macro-determinants, with the exception of gross domestic product per capita adjusted for purchasing power parity.
Conclusion. The macro-determinant of population health with the highest potential of effecting improvement in health conditions is to modify income inequality.
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References
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45. Rubio M. Perverse social capital-some evidence from Colombia. J Econ Issues. 1997;31:805-16.
46. Latorre-López MC. Sobre la relación positiva entre el capital social y la violencia urbana: un análisis teórico y empírico. Documento CEDE 2004-36. Bogotá DC: Universidad de los Andes; 2004.
47. Harpham T, Grant E, Rodríguez C. Mental health and social capital in Cali, Colombia. Soc Sci Med. 2004;58:2267-77.
48. Freedom House International. Freedom in the world. [Consultado: 4 de Julio de 2006]. Disponible en: http://www.freedomhouse.org/template.cfm?page=15
49. Franco A, Álvarez-Dardet C, Ruiz MT. Effect of democracy on health: ecological study. BMJ. 2004;329:1421-3.
50. Phipps AI, Clarke CA, Ereman RR. Impact of intercensal population projections and error of closure on breast cancer surveillance: examples from 10 California counties. Breast Cancer Res. 2005;7:R655-60.
51. Rose G. Sick individuals and sick populations. Int J Epidemiol. 1985;14:32-8.
52. World Health Organization. Towards a conceptual framework for analysis and action on the social determinants of health. Commission on Social Determinants of Health.; Discussion paper for the
Commission on Social Determinants of Health DRAFT. Geneva: WHO; 2005.
53. Braveman P. Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006;27:167-94.
54. Banco Mundial. Informe sobre el desarrollo mundial 2006. Equidad y Desarrollo. Washington D.C.: Banco Mundial; 2005.
55. Kaufman D, Kraay A, Maztruzzi M. Governance matters III: governance indicators for 1996-2002. Washington D.C.: World Bank; 2005.
2. Muntaner C, Lynch J. Income inequality, social cohesion, and class relations: a critique of Wilkinson's neo-Durkheimian research program. Int J Health Serv. 1999;29:59-81.
3. Carmona-Fonseca J. Cambios demográficos y epidemiológicos en Colombia durante el siglo XX. Biomédica. 2005;25:464-80.
4. MacKeown T. The role of medicine: dream, mirage, or Nemesis? London: Nuffield Provincial Hospital Trust; 1976.
5. Illich I. Medical Nemesis: the appropriation of health. London: Calder and Boyars; 1975.
6. McKinlay JB, McKinlay SM, Beaglehole R. A review of the evidence concerning the impact of medical measures on recent mortality in the United States. Int J Health Serv. 1989;19:181-208.
7. Bunker JP. The role of medical care in contributing to health improvements within societies. Int J Epidemiol. 2001;30:1260-3.
8. Dunn JR, Burgess B, Ross NA. Income distribution, public services expenditures, and all cause mortality in US States. J Epidemiol Community Health. 2005;59:768-74.
9. Gunning-Schepers LJ. That which we call social medicine.... J Epidemiol Community Health. 1997; 51: 224-6.
10. Krieger N. Theories for social epidemiology in the 21st century: An ecosocial perspective. Int J Epidemiol. 2001;30:668-77.
11. Barreto ML. The globalization of epidemiology: critical thoughts from Latin America. Int J Epidemiol. 2004;33:1132-7.
12. Wilkinson RG. Income distribution and life expectancy. BMJ. 1992;304:165-8.
13. Ram R. Further examination of the cross-country association between income inequality and population health. Soc Sci Med. 2006;62:779-91.
14. Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D. Social capital, income inequality, and mortality. Am J Public Health. 1997;87:1491-8.
15. Coburn D. Beyond the income inequality hypothesis: class, neo-liberalism, and health inequalities. Soc Sci Med. 2004;58:41-56.
16. Marmot M. Social determinants of health inequalities. Lancet. 2005;365:1099-104.
17. Moore S, Teixeira AC, Shiell A. The health of nations in a global context: trade, global stratification, and infant mortality rates. Soc Sci Med. 2006;63:165-78.
18. Wilkinson RG. The epidemiological transition: from material scarcity to social disadvantage? Daedalus. 1994;123:61-77.
19. Almeida-Filho N. O conceito de saúde: ponto-cego da epidemiologia? Rev Bras Epidemiol. 2000;3:4-20.
20. Organización Panamericana de la Salud. Las condiciones de salud en las Américas. Publicación científica No. 549, Volumen I. Washington: OPS; 1994.
21. Organización Mundial de la Salud. Colaboremos por la salud. Informe sobre la salud en el mundo. Geneva: OMS; 2006.
22. Agudelo CA. Colombia: tendencias de la población. Biomédica. 1994;14:160-71.
23. Omran AR. The epidemiologic transition. A theory of the epidemiology of population change. Milbank Mem Fund. Q 1971;49:509-38.
24. Frenk J, Frejka T, Bobadilla JL, Stern C, Lozano R, Sepúlveda J, et al. La transición epidemiológica en América Latina. Bol Of Sanit Panam. 1991;111:485-96.
25. Aviles LA. Epidemiology as discourse: the politics of development institutions in the epidemiological profile of El Salvador. J Epidemiol Community Health. 2001;55:164-71.
26. Gómez RD. La transición en epidemiología y salud pública: ¿explicación o condena? Rev Fac Nac Salud Pública. 2001;19:57-74.
27. Idrovo AJ. Posibles efectos en la salud asociados con la metalurgia precolombina. Biomédica. 2005;25:295-303.
28. Morgenstern H. Ecologic studies in epidemiology: Concepts, principles, and methods. Annu Rev Public Health. 1995;16:61-81.
29. McCann JC. A technique for estimating life expectancy with crude vital rates. Demography. 1976;13:259-72.
30. World Health Organization. World Health Report 2004: Cultural liberty in today's diverse world. Geneva: WHO; 2004.
31. Arriaga EE. Measuring and explaining the change in life expectancies. Demography. 1984;21:83-96.
32. United Nations Development Programme. World Report 2004. Cultural liberty in today's diverse world.New York: UNDP; 2004.
33. Milanovic B. A simple way to calculate the Gini coefficient, and some implications. Econ Lett. 1997;546:45-9.
34. Bjørnskov C. The multiple facets of social capital. Eur J Pol Econ. 2006;22:22-40.
35. Transparency International. Transparency International corruption perceptions index. Berlin: Transparency International Secretariat; 2004.
36. Islam MK, Merlo J, Kawachi I, Lindstrom M, Gerdtham UG. Social capital and health: Does egalitarianism matter? A literature review. Int J Equity Health. 2006;5:3.
37. Idrovo AJ. Capital social, muertes violentas y mortalidad por cáncer en Colombia: una aproximación poblacional. Rev Salud Pública (Bogotá). 2006;8:38-51.
38. Freedom House. Freedom in the World 2005: civic power and electoral politics. New York: Freedom House; 2005.
39. Elrich I, Lui F. Bureaucratic corruption and endogenous economic growth. J Pol Econ. 1999;107:s270-93.
40. Franco A, Álvarez-Dardet C, Ruiz MT. Effect of democracy on health: ecological study. BMJ. 2004;329:1421-3.
41. Bonilla-González R, González JI. Bien-estar y macroeconomía 2002-2006: el crecimiento inequitativo no es sostenible. Bogotá D. C.: Centro de Investigaciones para el Desarrollo/Universidad
Nacional de Colombia; 2006.
42. Meisel A, Vega M. A tropical success story: a century of improvements in the biological standard of living, Colombia 1910-2002. Cartagena: Centro de Estudios Económicos Regionales (CEER) - Cartagena, Banco de la República; 2004.
43. Offstein N. National, departmental and municipal rural agricultural land distribution in Colombia: Analyzing the web of inequality, poverty and violence. Documento CEDE 2005-37. Bogotá D.C.: Universidad de los Andes; 2005.
44. Pattussi MP, Moysés SJ, Junges JR, Sheiham A. Capital social e a agenda de pesquisa em epidemiologia. Cad Saúde Pública. 2006;22:1525-46.
45. Rubio M. Perverse social capital-some evidence from Colombia. J Econ Issues. 1997;31:805-16.
46. Latorre-López MC. Sobre la relación positiva entre el capital social y la violencia urbana: un análisis teórico y empírico. Documento CEDE 2004-36. Bogotá DC: Universidad de los Andes; 2004.
47. Harpham T, Grant E, Rodríguez C. Mental health and social capital in Cali, Colombia. Soc Sci Med. 2004;58:2267-77.
48. Freedom House International. Freedom in the world. [Consultado: 4 de Julio de 2006]. Disponible en: http://www.freedomhouse.org/template.cfm?page=15
49. Franco A, Álvarez-Dardet C, Ruiz MT. Effect of democracy on health: ecological study. BMJ. 2004;329:1421-3.
50. Phipps AI, Clarke CA, Ereman RR. Impact of intercensal population projections and error of closure on breast cancer surveillance: examples from 10 California counties. Breast Cancer Res. 2005;7:R655-60.
51. Rose G. Sick individuals and sick populations. Int J Epidemiol. 1985;14:32-8.
52. World Health Organization. Towards a conceptual framework for analysis and action on the social determinants of health. Commission on Social Determinants of Health.; Discussion paper for the
Commission on Social Determinants of Health DRAFT. Geneva: WHO; 2005.
53. Braveman P. Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006;27:167-94.
54. Banco Mundial. Informe sobre el desarrollo mundial 2006. Equidad y Desarrollo. Washington D.C.: Banco Mundial; 2005.
55. Kaufman D, Kraay A, Maztruzzi M. Governance matters III: governance indicators for 1996-2002. Washington D.C.: World Bank; 2005.
How to Cite
1.
Idrovo Álvaro J, Ruiz-Rodríguez M. A global view of population health in Colombia: role of social macro-determinants. biomedica [Internet]. 2007 Sep. 1 [cited 2024 May 19];27(3):333-44. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/196
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