Work

Disparidades en salud y determinantes legislativos en América Latina: análisis comparativo multivariado de la esperanza de vida, la mortalidad infantil y la inmunización en Chile, Colombia y Honduras (2011-2019)

Year: 2026

Type: article

Abstract: OBJECTIVE: To compare the evolution of health indicators and their relationship with legal frameworks and health policies in Chile, Colombia, and Honduras between 2011 and 2019. DESIGN: Retrospective ecological study of time series, with multivariate and comparative analysis. SETTING: Secondary national-level data from PAHO and WHO. PARTICIPANTS: General population, represented through indicators of life expectancy, infant mortality, and vaccination coverage. INTERVENTIONS: Review of laws, plans, and public health policies in force, including financing regulations and vaccination programs. MAIN MEASUREMENTS: Life expectancy at birth (years), infant mortality rate (per 1,000 live births), coverage of three doses of pneumococcal conjugate vaccine (PCV3, %), legal framework and health policies. ANALYSIS: MANOVA for multivariate differences, multiple linear regression adjusted by country and year, Pearson correlation, and assumption diagnostics. RESULTS: Significant heterogeneity was found among countries (Pillai's trace=1.0653; p < 0.001). In 2019, Chile showed the highest life expectancy (79.9 years) and the lowest infant mortality (7.04/1,000), while Honduras recorded the worst indicators (71.3 years; 18.8/1,000). PCV3 coverage was high and homogeneous (>90%) in all three countries. The correlation between life expectancy and infant mortality was very strong and inverse (r=-0.943; p < 0.001). CONCLUSIONS: Health disparities are explained by interactions among economic, institutional, and legislative factors. Reducing them requires strengthening the legal framework, increasing public health expenditure, and promoting international cooperation.

Source: Atención Primaria

DOI: 10.1016/j.aprim.2025.103428

Authors: Camilo Andrés Estupiñan Ruiz, Cristian Correa-Arrieta, Jeisson Andrés Hincapié-Carvajal

Institutions: Universidad El Bosque, Universidad Manuela Beltrán

Language: English

Topic: Global Maternal and Child Health

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities, Peace, justice, and strong institutions

Open Access status: gold

Estimated APC paid: $1,560