Burden and Territorial Distribution of Non-Communicable Diseases on the la Isla de la Juventud
Keywords:
chronic diseases; georeferencing; hospital case fatality; Health equity; information systems.Abstract
Introduction: The epidemiological burden of non-communicable diseases on la Isla de la Juventud from 2023 to 2024 was examined with a focus on spatial and operational patterns that explain disparities in mortality.
Objective: To determine mortality rates for non-communicable diseases in order to assess the impact of clinical-operational factors on hospital case fatality.
Methods: A retrospective observational study was conducted involving 913 validated deaths (based on ICD-10 criteria). The study utilized a census sample of adults (aged 30–69 years), excluding violent deaths and inconsistent records. The following variables were analyzed: age, sex, cause of death, geographic location (mapped using QGIS 3.28), and adherence to diagnostic protocols. Statistical analysis was performed using crude rates, years of life lost, and adjusted case fatality rates.
Results: Non-communicable diseases accounted for 82.9% of all deaths, with an annual increase of 54.9% specifically attributed to diabetes. Patients residing in the Pueblo Nuevo and Chacón areas exhibited the highest concentration of deaths due to tumors and heart diseases. Hospital fatality rates exceeded national targets (e.g., 37.4% vs. the 16% target for cerebrovascular events). Operational limitations included incomplete albuminuria testing records in 25.5% of cases, as well as prolonged shortages of laboratory reagents.
Conclusions: Non-communicable diseases constitute a health crisis driven by geographic and systemic determinants. The urban concentration of deaths highlights inequalities in access to healthcare services. These findings underscore the need for integrated policies that combine spatial surveillance, the strengthening of primary healthcare, and agile medical supply chain mechanisms. It is proposed that quantitative records be complemented with qualitative analyses regarding sociocultural barriers to care.
Downloads
References
1. Bai J, Cui J, Shi F, Yu CH. Global epidemiological patterns in the burden of main non-communicable diseases, 1990-2019: relationships with socio-demographic index. Int J Public Health. 2023;68:1605502. DOI: https://doi.org/10.3389/ijph.2023.1605502
2. Zhang JD, Cheng XF, Min SH, Guo RQ, Wang RN, He YT, et al. Burden of non-communicable diseases attributable to high temperature in a changing climate from 1990 to 2019: a global analysis. BMC Public Health. 2024;24:2475. DOI: https://doi.org/10.1186/s12889-024-19947-z
3. He C, Lu S, Yu H, Su Y, Zhang X. Global, regional and national disease burden attributable to high systolic blood pressure in youth and young adults: 2021 Global Burden of Disease Study analysis. BMC Med. 2025;23:74. DOI: https://doi.org/10.1186/s12916-025-03918-1
4. Chang AY, Jaminson T, Summers LH, Karlsson O, Mao W, Norheim OF, et al. Global health 2050: the path to halving premature death by mid-century. Lancet. 2024 [acceso 16/05/2025];404(10462):1561-614. Disponible en: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01439-9/abstractNCDI
5. Rasanathan K, Dako-Gyeke P, Isaranuwatchai W, Mahendraddhta Y, Robert M, Loffreda G, et al. Non-communicable diseases: can implementation research change the game for policy and practice? Lancet. 2024 [acceso 16/05/2025];404(10466):1908-10. Disponible en: https://www.thelancet.com/article/S0140-6736(24)01309-6/abstract.
6. Pan American Health Organization. Noncommunicable Diseases. Washington, D.C.: PAHO; 2024 [acceso 16/05/2025]. Disponible en: https://www.paho.org/en/topics/noncommunicable-diseases.
7. Mubarik S, Naeem S, Shen H, Mubarak R, Lou L, Hussain SR, et al. Population-level distribution, risk factors, and burden of mortality and disability-adjusted life years attributable to major noncommunicable diseases in Western Europe (1990-2021): Ecological Analysis. JMIR Public Health Surveill. 202 [acceso 16/05/2025]4;10(2024). Disponible en: https://publichealth.jmir.org/2024/1/e57840
8. García-Morales C, Heredia-Pi I, Guerrero-López CM, Orozco E, Ojeda-Arroyo E, Nijenda G, et al. Social and economic impacts of non-communicable diseases by gender and its correlates: a literature review. Int J Equity Health. 2024;23(1):274. DOI: https://doi.org/10.1186/s12939-024-02348-4
9. Cuban Ministry of Public Health. Health Statistical Yearbook 2023. Havana: MINSAP; 2024 [acceso 16/05/2025]. Disponible en: https://temas.sld.cu/estadisticassalud/2024/09/30/anuario-estadistico-de-salud-2023/.
10. Seuc AH, Mirabal-Sosa M, García-Serrano YAlfonso-Sague K, Fernández-González L. Mortality attributable to diabetes in Cuba: estimates for 2019. Public Health Pract (Oxf). 2024;8:100537. DOI: https://doi.org/10.1016/j.puhip.2024.100537
11. Soca PE, Sarmiento Y, Mariño AL, Llorente Y, Rodríguez T, Peña M. Prevalence of non-communicable chronic diseases and risk factors in older adults from Holguín. Rev Finlay. 2017 [acceso 16/05/2025];7(3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2221-24342017000300002
12. Shu J, Jin W. Prioritizing non-communicable diseases in the post-pandemic era based on a comprehensive analysis of the GBD 2019 from 1990 to 2019. Sci Rep. 2023;13:13325. DOI: https://doi.org/10.1038/s41598-023-40595-7
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Carlos Alexander Serrano Amador, Carmen Nuria Viguera Pozo
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The Cuban Journal of Medicine protects the author's patrimonial rights. However, it is licensed under a Creative Commons Licensehttps://creativecommons.org/licenses/by-nc/4.0/deed.es_ES which permits unrestricted non-commercial use, distribution and reproduction in any medium, provided that the primary source of publication is duly cited. The author always retains his moral rights.
You are free to:
- Share - copy and redistribute the material in any medium or format.
- Adapt - remix, transform and build upon the material
- The license cannot revoke these freedoms as long as you follow the terms of the license.
Under the following terms:
- Attribution - You must give proper credit, provide a link to the license, and indicate if changes have been made. You may do so in any reasonable manner, but not in such a way as to suggest that you or your use is supported by the licensor.
- Non-Commercial Purpose- You may not make use of the material for commercial purposes.
- No Additional Restrictions - You may not apply legal terms or technological measures that legally restrict others from making any use permitted by the license.
