Indigenous Mortality and Inequalities in Latin America: the cases of Brazil and Ecuador
Latin America (LA) has experienced rapid improvements in life expectancy, reduced poverty, and infant mortality. Although social-economic, and health disparities between indigenous and non-indigenous remain.
Mortality information by ethnicity isn’t available from most of LA countries.
The study aims to assess mortality inequalities between indigenous and non-indigenous in Brazil and Ecuador.
METHODS:
Census results from 2000/2010 from all LA countries’ Statistics Institutes were used to count indigenous and describing socio-demographic characteristics in Brazil and Ecuador. Brazil Ministry of Health and Ecuador National Institute of Statistics provided mortality data for 2010. Death certificates, including underlying causes of death coded using ICD-10 were used.
The leading causes of death for indigenous and non-indigenous were compared; crude and age-standardized mortality rates by causes were estimated, and rate ratio calculated.
RESULTS:
17 of 20 LA countries encompass 47 million indigenous, 9% of the population. There are 896,917 indigenous in Brazil (0.5% of the population) and 1,018,176 in Ecuador (7%).
In Brazil, urban areas comprise 36% of the indigenous and 85% of non- indigenous. Aged 15-under 36% are indigenous and 24% are non-indigenous. Illiteracy rate is 23% in indigenous and 9% among non-indigenous in aged 15- over.
In Ecuador, urban areas comprise 21% of the indigenous and 66% of non- indigenous. Aged 15-under are 37% of the indigenous and 31% of non- indigenous. Illiteracy rate is 23% among indigenous and 7% among non- indigenous in aged 15-over. Under-five mortality rates in indigenous were 2.5 and 1.6 fold of non- indigenous in Brazil and Ecuador respectively. In both, first cause of death was pneumonia-influenza among indigenous, killing significantly more indigenous aged 5-under and non-indigenous aged 70-over.
In Brazil, intestinal-infection was the third cause of death in indigenous, 6 times higher than non-indigenous and malnutrition/anemia was ranked fifth, 2.4 higher than non-indigenous. In Ecuador, malnutrition and anemia was ranked ninth, rate ratio of 2.4. In both countries, indigenous suicide rate was twice of non-indigenous, being 10 fold among indigenous aged 15-19.
CONCLUSIONS: Indigenous have social-demographic and mortality pattern of poverty: high birth and mortality rates, young population, rural residency, high illiteracy, and high infectious disease and malnutrition mortality rates.
Suicide is a leading cause of death among indigenous. Studies showed that high suicide rate among young indigenous result from discrimination and living between two worlds. Analysis using desagregated data by small areas showed that the homicides is high when there is fight for indigenous lands in a small area.
Inequality between indigenous and non-indigenous has existed for centuries. Indigenous are dying by avoidable causes, including high child mortality. They haven’t been benefited by social-economic and health improvements observed in LA.