BTN News: Colombia’s demographic and health profile has been undergoing significant transformations in recent years, reflecting broader global trends while also presenting unique challenges for public health authorities. The nation is grappling with a rapidly aging population, declining birth rates, and the persistent threat of chronic diseases. These shifts require urgent attention and a comprehensive response from both the government and the healthcare system to ensure the well-being of all citizens. In this analysis, we explore the key health issues facing Colombia, including the impact of an aging population, declining fertility rates, increasing life expectancy, rising instances of low birth weight, and the ongoing battle against chronic diseases and the HIV/AIDS epidemic.
The Rapidly Aging Population
Colombia’s population is aging at an unprecedented rate. Between 2019 and 2023, the population of individuals aged 60 and over increased by 16.9%. Projections indicate that this demographic will grow by an additional 11% by 2025. In stark contrast, the population of young children is shrinking. The first childhood (0-5 years) saw a population decrease of 5.1%, and the broader childhood (0-14 years) experienced a 0.7% decline when comparing 2023 with 2018.
These trends highlight a demographic shift that Colombia must address through targeted public policies. The growing proportion of elderly citizens demands specific programs tailored to their needs, particularly for those aged 80 and above and the centenarians, a group that includes over 22,000 individuals according to the National Administrative Department of Statistics (DANE). The decline in younger populations underscores the importance of planning for a future where fewer young people will support a growing elderly population.
Declining Fertility Rates: A Significant Drop in Births
Fertility rates in Colombia have seen a notable decline over the past few decades. From 1985 to 2015, there was a substantial decrease in fertility, and this trend has continued into the present. The average number of children per woman of reproductive age (15-49 years) dropped to 1.74 for the 2020-2025 period, a 3.4% decrease from the previous quinquennium. This decline in fertility is a critical factor in the country’s shifting demographic structure, with fewer children being born each year, which will have long-term implications for the country’s economy, social structures, and healthcare system.
Increasing Life Expectancy: A Success of the Health System
Colombia has seen a steady rise in life expectancy, a testament to the success of its healthcare system. From 1985-1990 to 2020-2024, life expectancy increased from 66.8 years to 75.7 years. Notably, women continue to outlive men, although the gap between the sexes is narrowing. This increase in longevity is a positive outcome, but it also brings challenges, particularly in managing the healthcare needs of an aging population and ensuring the quality of life for older adults.
The Rising Concern of Low Birth Weight
One worrying trend is the increase in low birth weight (defined as less than 2,500 grams) among newborns. In 2022, the incidence of low birth weight rose to 10.5%, a 6.3% increase from 2021 and a 26.4% increase compared to 2005. The DANE reported that this issue has been escalating steadily since 2020. The rise in low birth weight is concerning as it is often associated with higher risks of infant mortality, developmental issues, and long-term health problems. Addressing this issue requires targeted interventions in maternal health, nutrition, and prenatal care.
Chronic Diseases: The Leading Cause of Death
Chronic diseases, particularly cardiovascular diseases, continue to be the leading cause of death in Colombia. Preliminary data from 2023 revealed that ischemic heart diseases were responsible for 17.1% of all deaths, with 37,709 cases reported. Cerebrovascular diseases followed as the second leading cause, accounting for 6.4% of deaths with 14,166 cases. These statistics underscore the critical need for a comprehensive public health strategy focused on preventing chronic diseases through community-based programs that promote healthy diets, physical activity, smoking cessation, and air quality improvement.
The gender disparity in chronic disease mortality is narrowing, with women increasingly facing similar risks as men, particularly regarding ischemic heart disease. Factors contributing to this include rising obesity rates, smoking, and the multiple roles women often juggle as caregivers and providers.
COVID-19: The Pandemic’s Lingering Impact
Although the peak of the COVID-19 pandemic has passed, its effects are still felt. In the first four months of 2023, 542 confirmed COVID-19 deaths were reported, a significant decrease from the 9,718 deaths in 2022 and the 32,051 deaths in 2021. However, the pandemic’s shadow lingers, particularly among older adults, who continue to be the most affected group. Vaccination rates remain a concern, especially among those over 60, and it is unclear when COVID-19 vaccines will be fully integrated into Colombia’s expanded immunization plan.
The HIV/AIDS Epidemic: A Growing Challenge
The HIV/AIDS epidemic in Colombia continues to grow, with 166,496 cases reported in 2023. The prevalence of HIV has been steadily increasing, and only 43.5% of new cases are detected early. While 82.68% of those living with HIV are receiving therapy, the increasing number of cases highlights the need for improved early detection and ongoing support for those affected. The COVID-19 pandemic temporarily slowed the detection of new cases, but the upward trend has resumed, signaling the need for sustained efforts in prevention, testing, and treatment.
Maternal Mortality: Progress with Room for Improvement
Maternal mortality remains a critical issue, although recent years have seen some improvement. After a rise in maternal mortality rates during the COVID-19 pandemic, the rate decreased to 44.5 per 100,000 live births in 2023, down from a peak of 83.1 in 2021. Despite this progress, Colombia still falls short of its target to reduce maternal mortality to below 30.2 per 100,000 live births by 2030, as outlined in the National Development Plan and the Sustainable Development Goals. Continued efforts are necessary to further reduce maternal deaths and ensure safe pregnancies and deliveries for all women.
Gaps in Public Health Data: The Need for Updated Surveys
A significant challenge facing Colombia’s public health planning is the lack of recent population-based health surveys. The last National Mental Health Survey and the National Survey of the Nutritional Situation were conducted in 2015, and the most recent census was in 2018. These surveys are crucial for guiding health policy and resource allocation, yet they have not been updated as frequently as needed. The absence of up-to-date data hampers the ability to respond effectively to current health challenges, particularly in areas like nutrition and mental health.
The Path Forward: Strengthening Public Health in Colombia
Looking ahead, Colombia faces several critical challenges in public health that require immediate attention. The Ministry of Health must shift its focus from the ongoing healthcare reform to reinforcing health promotion and disease prevention, particularly in rural and remote areas. The modernization of the expanded immunization plan and the implementation of health promotion and maintenance pathways across all life stages are also crucial. Recovery in public health will depend on the collaboration between public and private healthcare networks and the enhancement of training for healthcare workers.
As Colombia navigates these challenges, it is essential to continue adapting to the changing demographic landscape, addressing the rise in chronic diseases, and ensuring that the healthcare system can meet the needs of an aging population. By focusing on prevention, improving data collection, and strengthening the healthcare workforce, Colombia can better manage its public health challenges and ensure a healthier future for all its citizens.
