Decoding health disparities by gender, ethnicity and chronic diseases across three Latin American countries

Chronic diseases disproportionately affect certain ethnic and gender groups, but the social determinants driving these disparities in Latin America are not fully understood. In this study, we analyzed data from national health surveys in Brazil, Mexico, and Ecuador (2018-2019), representing a total weighted population of 96,726,891 adults. We used random forest models to predict chronic disease diagnoses based on education, occupation, and access to essential services such as sanitation, drinking water, and garbage collection. Our models performed better for indigenous and afro-descendant people, highlighting significant inequalities. While occupation and education were strong predictors for women, decreasing model performance by 8.57% and 7.36% respectively, occupation was the critical variable for men, decreasing model performance by 19.6% when neutralized. This work highlights the need for public policies adapted to the specific needs of different ethnic and gender groups.

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Publication Details

Journal
Nature Communications
Published
2026-02-27
DOI
https://doi.org/10.1038/s41467-025-67564-0
Primary Topic
Child Nutrition and Water Access
Type
article
Field-Weighted Citation Impact
0.00

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article

Decoding health disparities by gender, ethnicity and chronic diseases across three Latin American countries

Carlos Chivardi, Daniella Medeiros Cavalcanti, José Alejandro Ordoñez, Davide Rasella et al.
Nature Communications
Child Nutrition and Water Access
article

Decoding health disparities by gender, ethnicity and chronic diseases across three Latin American countries

Carlos Chivardi, Daniella Medeiros Cavalcanti, José Alejandro Ordoñez, Davide Rasella, Alejandro Zamudio Sosa, Ana L. Moncayo, Cristina Almeida
article en

Abstract

Chronic diseases disproportionately affect certain ethnic and gender groups, but the social determinants driving these disparities in Latin America are not fully understood. In this study, we analyzed data from national health surveys in Brazil, Mexico, and Ecuador (2018-2019), representing a total weighted population of 96,726,891 adults. We used random forest models to predict chronic disease diagnoses based on education, occupation, and access to essential services such as sanitation, drinking water, and garbage collection. Our models performed better for indigenous and afro-descendant people, highlighting significant inequalities. While occupation and education were strong predictors for women, decreasing model performance by 8.57% and 7.36% respectively, occupation was the critical variable for men, decreasing model performance by 19.6% when neutralized. This work highlights the need for public policies adapted to the specific needs of different ethnic and gender groups.

Nature Communications
Universidade Federal da Bahia (BR), Swiss Tropical and Public Health Institute (CH), Pontificia Universidad Católica de Chile (CL), Pontificia Universidad Católica del Ecuador (EC), Barcelona Institute for Global Health (ES), University of York (GB), Universidad Nacional Autónoma de México (MX)
Medical Research Council
Gender equality
Openalex Percentile: Top 40%
Child Nutrition and Water Access
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