SPATIO-TEMPORAL DISTRIBUTION OF INFANT MORTALITY AND ITS RELATIONSHIP WITH CONTEXTUAL SOCIAL DETERMINANTS IN THE CITY OF CORDOBA, ARGENTINA.
DOI:
https://doi.org/10.31052/1853.1180.v25.n1.31157Keywords:
child mortality, social determinants, CórdobaAbstract
Aim: to characterize the temporal distribution of infant mortality rates (IMR) in the 2009-2018 decade, and to analyze the socio-spatial distribution of IMR and its relation with contextual social determinants in the triennium 2015-2017, in Cordoba city (Argentina).
Methods: a time trend (2009-2018) and a multiple groups ecological study (2015-2017) (n= 99 programmatic areas -PA-) was carried out. Data on IMR and social indicators were obtained from secondary data sources. The temporal evolution of IMRs, and the spatial distribution of IMRs and the proportion of households with unsatisfied basic needs (UBN) were described by means of descriptive measures and by maps. Spatial autocorrelation was assessed using the Moran index and relative inequality using the concentration index. Mixed Poisson regression models were fixed to estimate the association measures between the proportion of households with UBN and the IMR.
Results: there was a decreasing trend in IMRs in the period studied (11 ‰ in 2009 to 6.9 ‰ in 2018), although with a moderate increase in 2013. In the 2015-2017 triennium, the median IMR was of 9.35 ‰, with an interquartile range of 6.11 ‰. Spatial autocorrelation and relative inequality were identified in the indicators studied. The peripheries of the city presented higher IMR and proportions of households with UBN. The proportion of households with UBN level showed a direct association with IMRs (IRR = 1.05; 95% CI 1.025-1.075).
Conclusions: infant mortality in the city of Córdoba decreased in the 2009-2018 decade, and the socio-spatial distribution in the 2015-2017 triennium was heterogeneous. The IMR is conditioned by the degree of poverty of the PA. Measures to reduce IMRs must consider the contextual social determinants in Córdoba (Argentina).
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