Name of the Project
Geospatial inequalities in health: The case study of noncommunicable diseases in Bolivia
Lead researcher
Soraya Román, PhD
Pamela Cordova, PhD
Contact: sorayaroman@upb.edu, pcordova@upb.edu
Summary
Like many developing countries, Bolivia is in an epidemiological transition, where the burden of infectious diseases has been reduced while that of noncommunicable diseases (NCDs) is on the rise (Institute for Health Metrics and Evaluation, 2018). Some studies in Latin America show an association between the prevalence of these diseases and the socioeconomic status (SES) (Legetic, et al 2016; Goldstein et al 2005). However, the social distribution of the disease and its main determinants is less understood. A better understanding of inequities in NCDs in Latin American countries, including Bolivia, can help to understand their impact and reduce their incidence, especially among the most vulnerable. The literature that studies health inequalities has been focused on measuring and studying inequalities associated with racial / ethnic or socioeconomic differences (Bleich et al 2012). However, little was done to study health inequalities related to geospatial differences. Evidence from some middle and high-income countries, such as Brazil and the United States, shows that there are geographical differences in health after controlling for socioeconomic conditions, labor market and access to health services (Bortz et al 2015). This will be the focus of the proposal; that is to say, we propose to measure the degree of geospatial inequality in the burden of disease and risk factors of NCDs in Bolivia, at national and subnational level, to subsequently identify the main social variables associated with these inequalities. The study methodology will focus on the construction of a concentration index that measures inequality in health variables and risk factors of NCDs. For this, we will use the methodologies of Wagstaff et al (2008), at the national level, and Brady (2016), at the municipal level.