Infant mortality and living conditions: the reproduction of social inequalities in health during the 1990s
Costa, M.C.; Azi, P.A.; Paim, J.S.; da Silva, L.M.
Cadernos de Saude Publica 17(3): 555-567
2001
ISSN/ISBN: 0102-311X PMID: 11395793 Document Number: 251849
An ecological study was conducted in Salvador, Bahia State, Brazil to determine the infant mortality trend during the period 1991-97 and subsequently analyse its relationship to prevalent living conditions. Inequality patterns in infant death were analysed by spatial distribution and a compound socioeconomic index. The data showed a decline in the infant mortality rate, with neonatal deaths and perinatal causes playing a growing role. Despite this overall trend, the infant mortality rate increased in 1992. It was only in 1997 when it returned to the 1991 level. This observation was interpreted as related to worsening living conditions during that period. Spatial distributions highlighted the persistence of health inequalities; education was the variable with the most significant correlation rate. When distributed according to the living conditions index (LCI), both the infant mortality rate and proportional infant mortality showed a linear increase from the intermediate stratum (20.4%) to the lowest (29.3%) and from the highest stratum (5.3%) to the lowest (13.3%), respectively. The authors conclude that despite the reduction in the total infant mortality rate, the persistence of social inequalities and a social process that hinders improvement of living conditions are responsible for the inequalities observed in infant mortality.