Bayesian Model for Mortality Estimation by Diabetes in Colombia, Adjusted for Demographic Factors and Underestimation

Background: Diabetes-related mortality represents a major public health concern. However, official statistics frequently underestimate its true burden due to underreporting and misclassification, hindering effective policy design and resource allocation in Colombia. Objective: To estimate the true underlying diabetes mortality rates in Colombia from 1983 to 2018, adjusting for demographic factors (age, sex, and year) and underreporting in official records. Methods: National mortality and population data from 1983–2018 were stratified by age group, sex, and year. A Bayesian hierarchical negative binomial model was applied to estimate latent true mortality and reporting probabilities. True counts were modeled through negative binomial regression with demographic covariates and population offsets, while observed counts were modeled as a binomial sample of true counts to estimate reporting probability. Results: Substantial underreporting was identified (median reporting probability p = 0.72; 95% CI: 0.24–0.95). True mortality rates increased markedly with age (β₆₅⁺ = 2.91) and showed a slight male excess (βₘₐₗₑ = 0.08; 95% CI: 0.00–0.15). A significant decreasing trend over time was observed (βᵧₑₐᵣ = –0.024). Conclusion: Bayesian adjustment for underreporting provides more accurate estimates of diabetes mortality, revealing a considerably higher true burden than suggested by raw data. Although overall mortality rates exhibit a slow decline, pronounced age-related disparities persist. These refined estimates are essential to inform targeted, evidence-based public health interventions in Colombia.

• Autores: Díaz Valencia, Paula Andrea; Pérez Bedoya, Juan Pablo; Pérez Aguirre, Carlos Andrés; Barengo, Noël Christopher
• Tipo de recurso: http://purl.org/coar/resource_type/c_6670
• Fecha de publicación: 2025
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/47944
• Acceso en línea: https://hdl.handle.net/10495/47944
• Palabra clave: Diabetes Mellitus; Factores de Riesgo; Risk Factors; Estudio Observacional; Observational Study; Distribución por Edad y Sexo; Age and Sex Distribution; Diabetes Mellitus - mortalidad; Diabetes Mellitus - mortality; https://id.nlm.nih.gov/mesh/D003920; https://id.nlm.nih.gov/mesh/D012307; https://id.nlm.nih.gov/mesh/D064888; ODS 3: Salud y bienestar. Garantizar una vida sana y promover el bienestar de todos a todas las edades
• Rights: openAccess
• License: http://creativecommons.org/licenses/by-nc-sa/4.0/