Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010
OBJECTIVE: To explore distributional inequality of key health outcomes as determined by access coverage to water and sanitation (WS) between countries in the Region of the Americas. METHODS: An ecological study was designed to explore the magnitude and change-over-time of standard gap and gradient m...
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ftdoajarticles:oai:doaj.org/article:716a35a8ed5741e68938a67089f6361c 2023-05-15T15:12:58+02:00 Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010 Oscar J. Mújica Mariana Haeberer Jordan Teague Carlos Santos-Burgoa Luiz Augusto Cassanha Galvão https://doaj.org/article/716a35a8ed5741e68938a67089f6361c EN ES PT eng spa por Pan American Health Organization http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892015001000001&lng=en&tlng=en https://doaj.org/toc/1680-5348 1680-5348 https://doaj.org/article/716a35a8ed5741e68938a67089f6361c Revista Panamericana de Salud Pública, Vol 38, Iss 5, Pp 347-354 Health inequalities water sanitation environmental health social determinants of health Millennium Development Goals Sustainable Development Goals Americas Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article ftdoajarticles 2022-12-30T21:15:11Z OBJECTIVE: To explore distributional inequality of key health outcomes as determined by access coverage to water and sanitation (WS) between countries in the Region of the Americas. METHODS: An ecological study was designed to explore the magnitude and change-over-time of standard gap and gradient metrics of environmental inequalities in health at the country level in 1990 and 2010 among the 35 countries of the Americas. Access to drinking water and access to improved sanitation facilities were selected as equity stratifiers. Five dependent variables were: total and healthy life expectancies at birth, and infant, under-5, and maternal mortality. RESULTS: Access to WS correlated with survival and mortality, and strong gradients were seen in both 1990 and 2010. Higher WS access corresponded to higher life expectancy and healthy life expectancy and lower infant, under-5, and maternal mortality risks. Burden of life lost was unequally distributed, steadily concentrated among the most environmentally disadvantaged, who carried up to twice the burden than they would if WS were fairly distributed. Population averages in life expectancy and specific mortality improved, but whereas absolute inequalities decreased, relative inequalities remained mostly invariant. CONCLUSIONS: Even with the Region on track to meet MDG 7 on water and sanitation, large environmental gradients and health inequities among countries remain hidden by Regional averages. As the post-2015 development agenda unfolds, policies and actions focused on health equity-mainly on the most socially and environmentally deprived-will be needed in order to secure the right for universal access to water and sanitation. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English Spanish Portuguese |
topic |
Health inequalities water sanitation environmental health social determinants of health Millennium Development Goals Sustainable Development Goals Americas Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Health inequalities water sanitation environmental health social determinants of health Millennium Development Goals Sustainable Development Goals Americas Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Oscar J. Mújica Mariana Haeberer Jordan Teague Carlos Santos-Burgoa Luiz Augusto Cassanha Galvão Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010 |
topic_facet |
Health inequalities water sanitation environmental health social determinants of health Millennium Development Goals Sustainable Development Goals Americas Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
OBJECTIVE: To explore distributional inequality of key health outcomes as determined by access coverage to water and sanitation (WS) between countries in the Region of the Americas. METHODS: An ecological study was designed to explore the magnitude and change-over-time of standard gap and gradient metrics of environmental inequalities in health at the country level in 1990 and 2010 among the 35 countries of the Americas. Access to drinking water and access to improved sanitation facilities were selected as equity stratifiers. Five dependent variables were: total and healthy life expectancies at birth, and infant, under-5, and maternal mortality. RESULTS: Access to WS correlated with survival and mortality, and strong gradients were seen in both 1990 and 2010. Higher WS access corresponded to higher life expectancy and healthy life expectancy and lower infant, under-5, and maternal mortality risks. Burden of life lost was unequally distributed, steadily concentrated among the most environmentally disadvantaged, who carried up to twice the burden than they would if WS were fairly distributed. Population averages in life expectancy and specific mortality improved, but whereas absolute inequalities decreased, relative inequalities remained mostly invariant. CONCLUSIONS: Even with the Region on track to meet MDG 7 on water and sanitation, large environmental gradients and health inequities among countries remain hidden by Regional averages. As the post-2015 development agenda unfolds, policies and actions focused on health equity-mainly on the most socially and environmentally deprived-will be needed in order to secure the right for universal access to water and sanitation. |
format |
Article in Journal/Newspaper |
author |
Oscar J. Mújica Mariana Haeberer Jordan Teague Carlos Santos-Burgoa Luiz Augusto Cassanha Galvão |
author_facet |
Oscar J. Mújica Mariana Haeberer Jordan Teague Carlos Santos-Burgoa Luiz Augusto Cassanha Galvão |
author_sort |
Oscar J. Mújica |
title |
Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010 |
title_short |
Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010 |
title_full |
Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010 |
title_fullStr |
Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010 |
title_full_unstemmed |
Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010 |
title_sort |
health inequalities by gradients of access to water and sanitation between countries in the americas, 1990 and 2010 |
publisher |
Pan American Health Organization |
url |
https://doaj.org/article/716a35a8ed5741e68938a67089f6361c |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 38, Iss 5, Pp 347-354 |
op_relation |
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892015001000001&lng=en&tlng=en https://doaj.org/toc/1680-5348 1680-5348 https://doaj.org/article/716a35a8ed5741e68938a67089f6361c |
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1766343577951010816 |