Exploratory analysis of social gradients and inequalities in the use of solid fuels in latin america and the Caribbean

Introduction. The “percentage of population using solid fuels” is one of the indicators of the Millennium Development Goals (MDGs). It is related to child survival (MDG4) and maternal health (MDG5), and contributes to the cycle of poverty (MDG1). In this study we analyzed the distributional inequalities of solid fuels use (SFU) in total, rural, and urban populations in Latin America and the Caribbean (LAC) countries Methods. Data on prevalence of SFU, human development index (HDI) and urban/rural population in 2007 for 21 countries, comprising 98% of LAC total population, were retrieved from publicly available United Nations data sources. Proportion of SFU weighted by population size was computed for country quartiles of HDI distribution. Absolute Inequality in SFU was assessed by the slope index of inequality (SII) of a weighted least squares log-transformed linear regression of SFU prevalence on the ridit of social position defined by HDI. Relative inequality in SFU was assessed by the concentration index (CI). Results. An inverse gradient of SFU prevalence was found across the IDH country quartiles, from 56.1% in the lowest IDH quartile (weighted mean IDH: 0.685) to 5.0% in the highest IDH quartile (0.868); same effect was observed among urban and rural subpopulations; the rural:urban SFU prevalence ratio showed a direct gradient, from 2.3 to 11.7, respectively. The magnitude of inequality in SFU prevalence was -14.1% (SII); 58.2% of the population exposed to solid fuels was concentrated in the lowest quartile of HDI (CI=-0.45). Conclusion. The use of solid fuels is a neglected public health problem, and a significant contributor to health inequities in LAC. Greater awareness and urgent action on this environmental determinant of health are needed to achieve health related MDGs and equity.