All-Cause and Cervical Cancer Mortality by Ethnicity in Belize, 2008-2010

Abstract

INTRODUCTION: Belize is a lower middle income country. Life expectancy at birth is 76.3 years. There are distinct ethnic groups and
cultures. Continuous international research has confirmed the relationship between socioeconomic status and health. We have identified few studies on the social determinants of health in the Caribbean, thus the importance of disease surveillance. OBJECTIVE: To describe social determinants of mortality in Belize. METHODS: A cross-sectional descriptive study of mortality utilized the entire Belize population (2010 census data), multiplied by three to correspond with deaths over 3 years, ICD10 mortality classification of 2008 – 2010 to calculate deaths, all-cause, sex and cervical cancer mortality rates. Poisson's regression compared death rates between ethnicities, using the largest population group, the Mestizos as reference. RESULTS: There were 4,312 deaths in Belize, 2008 – 2010. Men had a 40% higher risk of death (IRR –Incidence Risk Ratio 1.4, 95% CI 1.3, 1.5). Crude death rate was 4.4/1,000 population, with highest rates among the dark skinned peoples of the Garifuna (7.9) and Creole (7.5) compared to light-skinned Mestizo (3.2) and Maya (3.3/1000) P-value<0.001. Cervical cancer mortality /100,000 women ≥20 years was 9.5 (n=42) ranging from 6.3 to 16.1 among the Mestizo and Maya respectively. CONCLUSIONS. Cervical cancer can and should be managed through screening by Pap smears or VIA (Visual Inspection with Acetic Acid) followed by therapy where indicated. The range of mortality rates by ethnicity in Belize indicates that cervical cancer screening and management programmes for Mayan women need to be reviewed.