20 years analysis of BRICS Countries
Research
Socioeconomic inequalities and mortality trends in BRICS, 1990–2010
Oscar J Mújica,a Enrique Vázquez,b Elisabeth C Duarte,c Juan J Cortez-Escalante,d Joaquin Molinab &
Jarbas Barbosa da Silva Juniord
Objective To explore the presence and magnitude of – and change in – socioeconomic and health inequalities between and within Brazil, the Russian Federation, India, China and South Africa – the countries known as BRICS – between 1990 and 2010.
Methods Comparable data on socioeconomic and health indicators, at both country and primary subnational levels, were obtained from publicly available sources. Health inequalities between and within countries were identified and summarized by using standard gap and gradient metrics.
Findings Four of the BRICS countries showed increases in both income level and income inequality between 1990 and 2010. The exception was Brazil, where income inequality decreased over the same period. Between-country inequalities in level of education and access to sanitation remained mostly unchanged but the largest between-country difference in mean life expectancy increased, from 9 years in
1990 to 20 years in 2010. Throughout the study period, there was disproportionality in the burden of disease between BRICS. However, the national infant mortality rate fell substantially over the study period in all five countries. In Brazil and China, the magnitude of subnational income-related inequalities in infant mortality, both absolute and relative, also decreased substantially.
Conclusion Despite the economic prosperity and general improvements in health seen since 1990, profound inequalities in health persist both within and between BRICS. However, the substantial reductions observed – within Brazil and China – in the inequalities in incomerelated levels of infant mortality are encouraging.
Introduction
One of the most pressing issues in the global agenda for health development is the pervasiveness of inequality. The World Economic Forum
Socioeconomic inequalities and mortality trends in BRICS, 1990–2010
Oscar J Mújica,a Enrique Vázquez,b Elisabeth C Duarte,c Juan J Cortez-Escalante,d Joaquin Molinab &
Jarbas Barbosa da Silva Juniord
Objective To explore the presence and magnitude of – and change in – socioeconomic and health inequalities between and within Brazil, the Russian Federation, India, China and South Africa – the countries known as BRICS – between 1990 and 2010.
Methods Comparable data on socioeconomic and health indicators, at both country and primary subnational levels, were obtained from publicly available sources. Health inequalities between and within countries were identified and summarized by using standard gap and gradient metrics.
Findings Four of the BRICS countries showed increases in both income level and income inequality between 1990 and 2010. The exception was Brazil, where income inequality decreased over the same period. Between-country inequalities in level of education and access to sanitation remained mostly unchanged but the largest between-country difference in mean life expectancy increased, from 9 years in
1990 to 20 years in 2010. Throughout the study period, there was disproportionality in the burden of disease between BRICS. However, the national infant mortality rate fell substantially over the study period in all five countries. In Brazil and China, the magnitude of subnational income-related inequalities in infant mortality, both absolute and relative, also decreased substantially.
Conclusion Despite the economic prosperity and general improvements in health seen since 1990, profound inequalities in health persist both within and between BRICS. However, the substantial reductions observed – within Brazil and China – in the inequalities in incomerelated levels of infant mortality are encouraging.
Introduction
One of the most pressing issues in the global agenda for health development is the pervasiveness of inequality. The World Economic Forum
References: Lancet. 2014;383(9917):630–67. doi: http://dx.doi.org/10.1016/S01406736(13)62407-1 PMID: 24524782 7. Wilson D, Trivedi K, Carlson S, Ursúa J 9. Emerging economies: when giants slow down. The Economist. 2013 July 27 Global Health. 2013;9(15). PMID: 23327564 12. Reidpath DD, Allotey P health. J Epidemiol Community Health. 2003;57(5):344–6. doi: http://dx.doi. 14. Milanovic BL. All the Ginis dataset (updated June 2013) [Internet]. and 2009: a systematic analysis. Lancet. 2010;376(9745):959–74. doi: http:// dx.doi.org/10.1016/S0140-6736(10)61257-3 PMID: 20851260 Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197–223. doi: http://dx.doi. 28. Table 1: Estimated birth rate, death rate, natural growth rate and infant mortality rate, 2000 29. Table 1: Estimated birth rate, death rate, natural growth rate and infant mortality rate, 2010