Serious health-related suffering in Latin America: a secondary analysis

Abstract

Evidence from needs analysis can support health systems and improve morbidity and mortality rates related to life-limiting and life-threatening conditions, and is essential for the development of health care and educational plans to respond adequately to the disease burden of the population. The aim of this study was to establish the number of people with serious health-related suffering, defined as a negative impact on the functioning (eg, physical, social, or emotional) of a patient with a serious illness that cannot be mitigated without medical intervention, in 19 Spanish-speaking and Portuguese-speaking Latin American countries in 1990, 2000, 2010, and 2019. We conducted a comparative secondary analysis of data from 19 Latin American countries reported on the Global Burden of Disease mortality database from the Institution for Health Metrics and Evaluation. Our analysis is premised on data generated by the Global Palliative Care and Pain Relief Research Hub spearheaded by the University of Miami's Institute for Advanced Study of the Americas. The number of people facing serious health-related suffering in Latin America doubled from 2 194 400, in 1990, to 4 268 500, in 2019. During this period, the increase in the percentage of people facing serious health-related suffering ranged from 39% (from 28 298 to 39 398 people) in Uruguay to 172% in Costa Rica (from 10 586 to 28 865 people), Panama (from 9770 to 26 651 people), and Venezuela (from 74 082 to 201 650 people). The number of no-decedents facing serious health-related suffering grew from 50% to 59% (vs decedents) during the period observed. People aged 70 years or older were the largest group facing serious health-related suffering in every country, which conversely decreased in children (aged 0-19 years). The most prevalent cause of serious health-related suffering was non-communicable disease, accounting for 63% (1990) to 72% (2019) of palliative care needs. Cancer was the largest single disease group accounting for the most serious health-related suffering in all years studied (20% in 1990; 22% in 2000; 24% in 2010; and 26% in 2019). The burden of serious health-related suffering in Latin America is large and growing. The comparison here presented shows a change in the cause of serious health-related suffering and a shift in the age groups affected, confirming an epidemiological and demographic transition in palliative care needs. None.