Population aging and social inequalities in the mortality of the elderly in Colombia

Abstract

Objective: to analyze the magnitude of population aging and the social inequalities existing in the mortality of the elderly in Colombia. Methodology: an ecological study which analyzed the breaches between the people via sub-national data on mortality, poverty, barriers preventing access to healthcare services, illiteracy and the elderly population. The trends of three impact indicators were calculated and compared: life expectancy (2005-2020), aging and over-aging indices (2005-2012). Furthermore, three measures were estimated to summarize absolute and relative inequality: the slope index of inequality (SII), Kunst and Makenbach’s relative index of inequality (RII) and the concentration index (CI). Results: The ratio of elderly people will be ever increasing in Colombia. The barriers preventing access to healthcare services were the most inequitable dimension. Two patterns of inequality were identified: a marginal exclusion for 60% of the elderly who had the most advantages and opportunities, and a linear gradient pattern existing only in the incidence of poverty. The third quintile was the group of departments most affected by the inequity throughout the assessed social dimensions. Discussion: This study provides evidence of inequality patterns in the mortality of the elderly. Regarding the trends, it was only possible to know that the breach has become larger in terms of poverty incidence. Conclusions: Five areas of action are described in order to achieve a desirable context to address population aging and the reduction of social inequalities as challenges for the healthcare and social protection system. These challenges may undermine the progressive realization of universal healthcare coverage and the achievement of sustainable development goals by 2030.