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).
Downloads
References
Onambele L, San Martin-Rodríguez L, Niu H, Alvarez-Alvarez I, Arnedo-Pena A, Guillen-Grima F, Aguinaga-Ontoso I. Mortalidad infantil en la Unión Europea: análisis de tendencias en el período 1994-2015. An Pediatr (Barc). 2019; 91(4):219-27.
Shrivastava SR, Shrivastava PS, Ramasamy J. Medidas de salud pública para reducir la mortalidad infantil. J Educ Health Promot. 2014; 3: 87.
World Health Organization (WHO). More women and children survive today than ever before – UN report. [Internet]. 2019 [Consultado 22 Abr 2020]. Disponible en: https://www.who.int/es/news-room/detail/19-09-2019-more-women-and-children-survive-today-than-ever-before-un-report
UNICEF, WHO, World Bank, UN-DESA Population Division. Levels and trends in child mortality. 2015; New York.
United Nations Inter-agency, Group for Child Mortality Estimation. Levels & Trends in Child Mortality: Report 2019. [Internet]. 2019. [Consultado 29 Abr 2020]. Disponible en: https://data.unicef.org/resources/levels-and-trends-in-child-mortality/
CEPAL. La pobreza infantil: un desafío prioritario. [Internet]. 2010. [Consultado 12 May 2020]. Disponible en: https://repositorio.cepal.org/bitstream/handle/11362/35996/1/Boletin-Desafios10-CEPAL-UNICEF_es.pdf
Behm H. Los determinantes de la mortalidad y las diferencias socioeconómicas de la mortalidad en la infancia. Población y Salud en Mesoamérica. 2014; 12(1).
Requejo JH, Bryce J, Barros AJ, Berman P, Bhutta Z, et al. Countdownto 2015 and beyond: fulfillingthehealth agenda forwomen and children. Lancet. 2015;385(9966):466–76.
Kraft AD, Kim-Huong N, Jiménez-Soto E, Hodge A. Stagnant neonatal mortality and persisting health inequality in middel-income contutries: a case of sudy of Philippines. PLoS ONE. 2015; 8(1), 1-13.
Ministerio de Salud Secretaría de Acceso a la Salud, Subsecretaría de Medicamentos e Información Estratégica, Dirección de Estadísticas e Información en Salud. Defunciones de menores de cinco años Indicadores seleccionados. Argentina – Año 2018. 2020¸Boletín Número 161 Buenos Aires, ISSN: 0301-4630.
Bossio JC, Sanchis I, Herrero MB, Armando GA, Arias SJ. Mortalidad infantil y desigualdades sociales en Argentina, 1980-2017. 2020; Revista Panamericana de Salud Pública, 44.
Ramalho WM, Sardinha LM, Rodrigues IP, Duarte EC. Inequalities in infant mortality among municipalities in Brazil according to the Family Development Index, 2006-2008. Rev Panam Salud Publica. 2013;33(3):205-212.
Carvalho RA, Santos VS, Melo CM, Gurgel RQ, Oliveira CC. Inequalities in health: living conditions and infant mortality in Northeastern Brazil. Rev Saude Publica. 2015; 49:5. doi:10.1590/s0034-8910.2015049004794
Instituto Nacional de Estadísticas y Censos (INDEC). Censo Nacional de Población, Hogares y Viviendas 2010 [Internet]. 2010. Ciudad Autónoma de Buenos Aires: INDEC. [consulta: 1 Nov 2019]. Disponible en: https://www.indec.gob.ar/indec/web/Institucional-Indec-BasesDeDatos-6
Municipalidad de Córdoba. Córdoba una ciudad en cifras. Guía estadística de la ciudad de Córdoba. [Internet]. 2018. [Consultado 12 May 2020]. Disponible en:
Moran PA. The interpretation of statistical maps. Journal of the Royal Statistical Society Series B (Methodological). 1948; 10:243–51
Herrero M, Bossio JC. Determinantes sociales de la mortalidad infantil por causas reducibles en la Argentina, 2009-2011. Población y Salud en Mesoamérica. 2017; 15(1).
Finkelstein JZ, Duhau M, Speranza A, Marconi E, Escobar P. Evolución de la mortalidad infantil en Argentina en el marco de los Objetivos de Desarrollo del Milenio. Archivos argentinos de pediatría. 2016;114(3), 216-222.
Ministerio de Salud, Secretaría de Acceso a la Salud, Subsecretaría de Medicamentos e Información Estratégica, Dirección de Estadísticas e Información en Salud. Estadísticas vitales. Información básica Argentina - Año 2018. 2019; Serie 5 Número 62 Buenos Aires.
Brisson ME, García Conde S, Di Pietro L. Objetivos de Desarrollo del Milenio. La Cumbre del Milenio y los compromisos internacionales. Buenos Aires: Consejo Nacional de Coordinación de Políticas Sociales. [Internet]. 2014. [Consultado 12 Sep 2020]. Disponible en: http://www.politicassociales.gov. ar/odm/ODM_SerieDocumentoTrabajo/ODM_ SerieDocumentoTrabajoN1.pdf
Sartorius BK, Sartorius K, Chirwa TF, Fonn S. Infant mortality in South Africa-distribution, associations and policy implications, 2007: an ecological spatial analysis. International journal of health geographics. 2011; 10(1), 61.
Alvarez G, Lara F, Harlow SD, Denman C. Mortalidad infantil y marginación urbana: análisis espacial de su relación en una ciudad de tamaño medio del noroeste mexicano. Rev Panam Salud Publica. 2009; 26(1):31-8.
Cervio AL. Expansión urbana y segregación socio-espacial en la ciudad de Córdoba (Argentina) durante los años ‘80. Astrolabio. 2015; (14):360-92.
Lynch JW, Kaplan GA, Pamuk ER, Cohen RD, Heck KE, Balfour JL, Yenm I. Income inequality and mortality in metropolitan areas of the United States. American Journal of Public Health. 1998; 88(7), 1074-80.
Ramalho WM, Sardinha LM, Rodrigues IP, Duarte EC Inequalities in infant moratality among municipalities in Brazil according to the Family Development Index, 2006-2008. Revista Panamericana de Salud Pública. 2013; 205-12.
Valdivia M. Acerca de la magnitud de la inequidad en salud en el Perú. (Documento de Trabajo, 37). Lima: GRADE Group for the Analysis of Development. [Internet]. 2002. [Consultado 10 Sep 2020]. Disponible en: https://www.ssoar.info/ssoar/bitstream/handle/document/51481/ssoar-2002-valdivia-Acerca_de_la_magnitud_de.pdf?sequence=3
Flores M, Cerdas J. Evolución de las desigualdades en la mortalidad infantil. Archivos de Pediatría del Uruguay. 2012; 83(2), 139-43.
Cardona D, Acosta LD, Bertone CL. Inequidades en salud entre países de Latinoamérica y el Caribe (2005-2010). Gac Sanit. 2013; 27(4):292-7.
Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia. Mortalidad Materna e Infantil en Bogotá, Seguimiento y Análisis de Inequidades 2005-2011. 2012; Bogotá: Alcaldia de Bogotá.
Chamizo García HA, Behm Ammazzini I. Las inequidades geográficas en la mortalidad infantil en Costa Rica, período 2008-2012. Población y Salud en Mesoamérica. 2014; 12 (1).
Ortigoza AF, Tapia Granados JA, Miranda JJ, Alazraqui M, Higuera D, Villamonte G, Friche AAL, Barrientos Gutierrez T, Diez Roux AV. Characterising variability and predictors of infant mortality in urban settings: findings from 286 Latin American cities. J Epidemiol Community Health. 2020; doi: 10.1136/jech-2020-215137.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Escuela de Salud Pública y Ambiente. Facultad de Ciencias Médicas. Universidad Nacional de Córdoba
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License which allows the work to be copied, distributed, exhibited and interpreted as long as it is not done for commercial purposes.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) after the publication process. (See The Effect of Open Access). (See The Effect of Open Access).
