eprintid: 28573 rev_number: 9 eprint_status: archive userid: 2 dir: disk0/00/02/85/73 datestamp: 2026-05-15 23:30:12 lastmod: 2026-05-15 23:30:13 status_changed: 2026-05-15 23:30:12 type: article metadata_visibility: show creators_name: López Muñoz, Italo Salvador creators_name: Romero Ladrón de Guevara, Maria Loreto creators_name: Mejia, Christian R. creators_name: Del-Aguila-Arcentales, Shyla creators_name: Alvarez-Risco, Aldo creators_name: Davies, Neal M. creators_name: Yáñez, Jaime A. creators_id: italo.lopez@doctorado.unini.edu.mx creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: title: Association between socioeconomic and health variables and community-acquired pneumonia mortality rates in Chile from 1990 to 2021 ispublished: pub subjects: uneat_bm subjects: uneat_cs divisions: uninimx_produccion_cientifica full_text_status: public keywords: Pneumonia; Mortality; Chile; Socioeconomic factors; Epidemiology abstract: Objectives To describe long-term trends in mortality attributed to community-acquired pneumonia (CAP) in Chile from 1990 to 2021, stratified by age group, and to evaluate associations with selected socioeconomic and demographic indicators. Study design Ecological, observational, longitudinal study using national secondary data. Methods CAP mortality rates were analyzed for the total population and by age group. Associations with the Human Development Index (HDI), poverty rate, aging index, and life expectancy at birth were examined using a hierarchical analytical approach. This included Spearman's rank correlation for initial exploration, multivariable linear regression to assess adjusted associations, and Prais–Winsten generalized least squares regression to account for first-order autocorrelation and shared temporal trends. Stationarity was evaluated using augmented Dickey–Fuller tests, with supplementary analyses using first-differenced variables. Missing data were imputed using time-based regression or interpolation, with sensitivity analyses performed. Results CAP mortality declined substantially across all age groups over the study period. Strong bivariate correlations were observed between mortality and all socioeconomic indicators; however, these associations were attenuated after adjustment for confounding and temporal autocorrelation. In multivariable and time-series models, HDI and the aging index remained significantly associated with CAP mortality in children (0–9 years) and older adults (≥65 years), whereas associations in intermediate age groups were not robust after accounting for shared secular trends. Poverty and life expectancy did not demonstrate independent associations in adjusted models. Conclusions CAP mortality in Chile has decreased markedly over the past three decades. Associations with socioeconomic indicators are strongest at the extremes of age and persist after accounting for temporal structure, although the ecological design precludes causal inference. These findings highlight the importance of considering demographic and socioeconomic context in population-level analyses of infectious disease outcomes. date: 2026-05 publication: Public Health volume: 256 pagerange: 106315 id_number: doi:10.1016/j.puhe.2026.106315 refereed: TRUE issn: 00333506 official_url: http://doi.org/10.1016/j.puhe.2026.106315 access: open language: en citation: Artículo Materias > Biomedicina Materias > Ciencias Sociales Universidad Internacional Iberoamericana México > Investigación > Artículos y libros Abierto Inglés Objectives To describe long-term trends in mortality attributed to community-acquired pneumonia (CAP) in Chile from 1990 to 2021, stratified by age group, and to evaluate associations with selected socioeconomic and demographic indicators. Study design Ecological, observational, longitudinal study using national secondary data. Methods CAP mortality rates were analyzed for the total population and by age group. Associations with the Human Development Index (HDI), poverty rate, aging index, and life expectancy at birth were examined using a hierarchical analytical approach. This included Spearman's rank correlation for initial exploration, multivariable linear regression to assess adjusted associations, and Prais–Winsten generalized least squares regression to account for first-order autocorrelation and shared temporal trends. Stationarity was evaluated using augmented Dickey–Fuller tests, with supplementary analyses using first-differenced variables. Missing data were imputed using time-based regression or interpolation, with sensitivity analyses performed. Results CAP mortality declined substantially across all age groups over the study period. Strong bivariate correlations were observed between mortality and all socioeconomic indicators; however, these associations were attenuated after adjustment for confounding and temporal autocorrelation. In multivariable and time-series models, HDI and the aging index remained significantly associated with CAP mortality in children (0–9 years) and older adults (≥65 years), whereas associations in intermediate age groups were not robust after accounting for shared secular trends. Poverty and life expectancy did not demonstrate independent associations in adjusted models. Conclusions CAP mortality in Chile has decreased markedly over the past three decades. Associations with socioeconomic indicators are strongest at the extremes of age and persist after accounting for temporal structure, although the ecological design precludes causal inference. These findings highlight the importance of considering demographic and socioeconomic context in population-level analyses of infectious disease outcomes. metadata López Muñoz, Italo Salvador; Romero Ladrón de Guevara, Maria Loreto; Mejia, Christian R.; Del-Aguila-Arcentales, Shyla; Alvarez-Risco, Aldo; Davies, Neal M. y Yáñez, Jaime A. mail italo.lopez@doctorado.unini.edu.mx, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR (2026) Association between socioeconomic and health variables and community-acquired pneumonia mortality rates in Chile from 1990 to 2021. Public Health, 256. p. 106315. ISSN 00333506 document_url: http://repositorio.unini.edu.mx/id/eprint/28573/1/1-s2.0-S0033350626001848-main.pdf