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Background: This study examined the variation in city-level amenable mortality, i.e. mortality due to conditions that can be mitigated in the presence of timely and effective healthcare, in 363 Latin American cities and measured associations between amenable-mortality rates and urban metrics.Methods: We used death records from 363 cities with populations of >100 000 people in nine Latin American countries from 2010 to 2016. We calculated sex-specific age-adjusted amenable-mortality rates per 100 000. We fitted multilevel linear models with cities nested within countries and estimated associations between amenable mortality and urban metrics, including population size and growth, fragmentation of urban development and socio-economic status.Results: Cities in Mexico, Colombia and Brazil had the highest rates of amenable mortality. Overall, >70% of the variability in amenable mortality was due to between-country heterogeneity. But for preventable amenable mortality, those for which the healthcare system can prevent new cases, most of the variability in rates occurred between cities within countries. Population size and fragmentation of urban development were associated with amenable mortality. Higher fragmentation of urban development was associated with lower amenable mortality in small cities and higher amenable mortality in large cities. Population growth and higher city-level socio-economic status were associated with lower amenable mortality.Conclusions: Most of the variability in amenable mortality in Latin American cities was due to between-county heterogeneity. However, urban metrics such as population size and growth, fragmentation of urban development and city-level socio-economic status may have a role in the distribution of amenable mortality across cities within countries. [ABSTRACT FROM AUTHOR]

Background: Latin America is one of the most unequal regions in the world, but evidence is lacking on the magnitude of health inequalities in urban areas of the region. Our objective was to examine inequalities in life expectancy in six large Latin American cities and its association with a measure of area-level socioeconomic status., Methods: In this ecological analysis, we used data from the Salud Urbana en America Latina (SALURBAL) study on six large cities in Latin America (Buenos Aires, Argentina; Belo Horizonte, Brazil; Santiago, Chile; San José, Costa Rica; Mexico City, Mexico; and Panama City, Panama), comprising 266 subcity units, for the period 2011-15 (expect for Panama city, which was for 2012-16). We calculated average life expectancy at birth by sex and subcity unit with life tables using age-specific mortality rates estimated from a Bayesian model, and calculated the difference between the ninth and first decile of life expectancy at birth (P90-P10 gap) across subcity units in cities. We also analysed the association between life expectancy at birth and socioeconomic status at the subcity-unit level, using education as a proxy for socioeconomic status, and whether any geographical patterns existed in cities between subcity units., Findings: We found large spatial differences in average life expectancy at birth in Latin American cities, with the largest P90-P10 gaps observed in Panama City (15·0 years for men and 14·7 years for women), Santiago (8·9 years for men and 17·7 years for women), and Mexico City (10·9 years for men and 9·4 years for women), and the narrowest in Buenos Aires (4·4 years for men and 5·8 years for women), Belo Horizonte (4·0 years for men and 6·5 years for women), and San José (3·9 years for men and 3·0 years for women). Higher area-level socioeconomic status was associated with higher life expectancy, especially in Santiago (change in life expectancy per P90-P10 change unit-level of educational attainment 8·0 years [95% CI 5·8-10·3] for men and 11·8 years [7·1-16·4] for women) and Panama City (7·3 years [2·6-12·1] for men and 9·0 years [2·4-15·5] for women). We saw an increase in life expectancy at birth from east to west in Panama City and from north to south in core Mexico City, and a core-periphery divide in Buenos Aires and Santiago. Whereas for San José the central part of the city had the lowest life expectancy and in Belo Horizonte the central part of the city had the highest life expectancy., Interpretation: Large spatial differences in life expectancy in Latin American cities and their association with social factors highlight the importance of area-based approaches and policies that address social inequalities in improving health in cities of the region., Funding: Wellcome Trust., (Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)