Association between oral cancer mortality and public health expenditure in Colombia between 2012 and 2022: an ecological study: un estudio ecológico^*

Objective: To analyze the association between oral cancer mortality and public health expenditure in Colombia between 2012 and 2022. Methods: An ecological study was conducted, analyzing age-adjusted mortality trends per 100,000 inhabitants. The association was explored using a multilevel model that incorporated per capita public health expenditure, year, and department as covariates. Results: Per capita public health expenditure had a median of $26,279, a minimum of $9,576, and a maximum of $589,278. Nationally, the mortality rate for 2022 for men was 2.42 (95% CI: 2.21–2.63), and for women, 1.66 (95% CI: 1.49–1.84). The departments with the highest mortality rates for men were Santander, Tolima, and Meta; for women, Santander, Risaralda, and Bogotá. Increasing trends were observed for both sexes. The multilevel model showed an increasing mortality rate, with a mean per capita expenditure of 0.042 per million (95% CI: 0.000019–0.93; p = 0.04). Conclusions: A positive association was observed between public health expenditure and mortality. In addition, an increasing rate of mortality from oral cancer was observed in Colombia.