[Excess mortality in winter in Argentina from 1997 to 2017: an approach based on public health and an epistemic dispute from the Global South].

Excess mortality in winter is studied in the Global North as a manifestation of social inequalities and avoidable deaths. It has a complex identification that differs from general mortality. This study aims to highlight the occurrence of excess winter mortality in Argentina from 1997 to 2017. Also, it describes excess mortality magnitude, trend, and distribution in order to discuss it based on a critical perspective as an object of knowledge for public health. Official mortality databases were used for a study of time series at the national, regional and provincial levels, integrating spatial and temporal aggregates. In total, 407,950 excess deaths were identified in winter, with an annual average of 16,667 (20.4%; 95%CI: 18.6; 22.2). A higher prevalence was found in women (21.8%; 95%CI: 20.5; 24.9) than in men (18.2%; 95%CI: 16.2; 19.5). Of this total, 92.3% occurred in older women aged over 60 years, with a predominance of those older than 80 years (63%) and men aged from 60 to 79 years (49.7%). Excess winter mortality was also found in children aged under 5 years, but not in men aged 15 to 29 years. The nadir occurred in 2010 (15%; 95%CI: 14.7; 15.2) and the peak in 1999 (30.5%; 95%CI: 30.2; 30.9). Latitude explained 75% of the variability between provinces (adjusted R² = 0.75). It is concluded that women, children aged under 5 years, older people aged over 60 years and residents of the Central and Cuyo regions were the most affected. Based on a proxy indicator, this work shows inequalities in mortality that are probably unfair and avoidable, synthesizing individual and collective vulnerabilities. Its pioneering aspect lies in carrying out a critical approach from the Global South, providing knowledge relevant to Public Health.