The paradisiac town of Acapulco, the pearl of the Pacific, is a highly desired tourist destination for its miles of beaches.
But outside the hotels, the situation does not seem like a paradise: 19% of the city's deaths are due to the violence that terrorizes its streets, one of the highest percentages in Latin America.
Life expectancy at birth there for a man is just 63 years.
They are 14 years less than the years that are around in many cities in Chile, Peru and Costa Rica.
A demonstration of the gigantic inequalities that exist between Latin American cities and that highlights a study published today in
Nature Medicine
, which analyzes the longevity and mortality of 363 cities in nine countries.
Violence is one of the most brutally unequal causes of death on the continent.
In the tables, cities such as Acapulco or Porto Seguro (Brazil) stand out, with percentages similar to those that can be found in Iraq, while at the other extreme cities such as Lima (Peru) or Valparaíso (Chile) appear with very low percentages and levels of life expectancy comparable to those in rich countries.
"What we do here is show that depending on the city you live in, your life expectancy will vary a lot," says one of the study authors, Usama Bilal, from Drexler University (USA).
And although violence is closely associated with men, women are also victims.
"The city with the lowest life expectancy for Mexican women is precisely Juárez," says Bilal, referring to a city known for its numerous femicides.
"Normally we compare the life expectancy of countries that have it very high, such as Spain and Japan, with others that have it very low, such as Afghanistan and Botswana", explains this epidemiologist. "But here we see that within the same country, such as Mexico o Brazil, there are cities with very high and very low hope of high: we have data like those of Germany and less than those of India, like in Acapulco.
Within Mexico we have many different countries ”, adds Bilal.
One of the things that draws the attention of researchers from all these countries is also the differences in the causes of death between cities in the same country.
The northern regions of Argentina, with a very high number of deaths from infectious diseases, have a very different profile from Buenos Aires.
Brazil, for example, has very different patterns of violence: little in the south and very high values in the north.
If something stands out from this research, it is that it is not the city as such - as opposed to rural areas - that generates health conditions, but rather the type of city.
“Studies like this are important because they suggest that urban policies have an impact on health.
Improving health in cities requires policies in interventions that go far beyond medical care, ”says Ana Diez Roux, principal investigator of the SALURBAL (Urban Health in Latin America) project.
The sample is made up of cities with more than 100,000 inhabitants from the nine countries that have scientists in the project: Colombia, Mexico, Chile, Peru, Brazil, Argentina, Costa Rica, Panama and El Salvador.
Data from 2010 to 2016 have been used in this study.
The researchers analyzed what factors are associated with the level of life expectancy and found that the most decisive thing is what they call the social environment index, a mixture of four indicators: the proportion of people who have completed primary education, who have access to water in their house, which is connected to the sanitation network and, finally, the proportion of inhabitants living in overcrowded situations.
“This implies that the city is more developed, economically and socially.
And we see that it is very predictive of life expectancy ”, sums up Bilal, who received two million dollars in 2018 to study how cities affect people's health.
The project involves analyzing more than 700 cities throughout the American continent, including the US.
This same team published in December 2019 another study in which it studied these same factors within cities, and they discovered data such as that a woman who resides in one of the less favored areas of Santiago de Chile will live 18 years less than another woman who live in a rich neighborhood in your own city.
"Here we see up to 14 years of life between cities, but if we look within the cities we would observe even more inequality: if we compared the poor of Acapulco with the rich of Santiago, the differences would be much greater," says Bilal.
One of the main problems they have had when collecting and analyzing data is a phenomenon, that of undercounting: not all deaths end up in the civil registry.
“If we don't have them accounted for, it may seem that life expectancy is higher than it really is.
It is a very big problem in Peru, where a high percentage of deaths, around 40%, were not registered, ”says Bilal.
Although they applied statistical methods to correct it, it may explain why there are Peruvian cities in which the life expectancy of men is so high.
Data from 2010 to 2016 have been used in this study.
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