Gutiérrez G, Reyes H, Fernández S, Pérez L, Pérez-Cuevas R, Guiscafré H
Grupo Interinstitucional de Investigación en Sistemas de Salud, Secretaría de Salud e Instituto Mexicano del Seguro Social, México.
Salud Publica Mex. 1999 Sep-Oct;41(5):368-75.
To analyze differences of the impact of health care services, sanitation and literacy on the mortality rates of children under five years of age, in two Mexican states with marked socioeconomic differences: Chiapas and Nuevo Leon.
The study design was ecologic, based on a retrospective analysis of data published by the Health Ministry (Secretaría de Salud), National Institute of Statistics, Geography and Informatics (Instituto Nacional de Estadística, Geografía e Informática) and the National Population Council (Consejo Nacional de Población), on the tendencies of mortality among children under five years and on the changes of selected indicators corresponding to the period 1990-1997.
ecologic study. This was based on a retrospective analysis of data published by Secretaría de Salud, Instituto Nacional de Estadística e Informática and Consejo Nacional de Población, about the tendencies of mortality among children under five years, and about the changes of selected indicators. The analysis was carried out in the period comprised between 1990-1997. For both states the registered variations were calculated and the trends were determined through analysis of simple linear regression; the independent variable corresponded to the study years. Partial correlation analysis between the various mortality trends studies and between and the selected indicators, were calculated.
During the studied period there was a steady decline of children mortality, which was more marked in Chiapas. In both entities, this decrease was closely related to the decline in mortality due to acute diarrhea, and also correlated with a descent in measles and acute respiratory infections. In Chiapas, the indicators which correlated more significantly with this decline in mortality were vaccination coverage and literacy. In Nuevo Leon, the indicators with greater correlation were the increase in the number of nurses, of lodgings with piped water and vaccination coverage.
During the analyzed period, the mortality rate of children under five years of age decreased in the states of Chiapas and Nuevo Leon. To sustain or accelerate the decline in childhood mortality it is mandatory to continue with the currently implemented programs, and in Chiapas, and similar states, to increase the available infrastructure to provide health care.
分析医疗卫生服务、卫生设施和识字率对墨西哥两个社会经济差异显著的州（恰帕斯州和新莱昂州）五岁以下儿童死亡率的影响差异。
本研究设计为生态学研究，基于对卫生部（卫生部）、国家统计、地理与信息研究所（国家统计、地理与信息研究所）和国家人口委员会（国家人口委员会）公布的数据进行回顾性分析，这些数据涉及五岁以下儿童的死亡率趋势以及1990 - 1997年期间选定指标的变化。
生态学研究。这基于对卫生部、国家统计与信息研究所和国家人口委员会公布的数据进行回顾性分析，这些数据关于五岁以下儿童的死亡率趋势以及选定指标的变化。分析在1990 - 1997年期间进行。计算了两个州的登记变化，并通过简单线性回归分析确定趋势；自变量对应研究年份。计算了各种死亡率趋势研究之间以及与选定指标之间的偏相关分析。
在研究期间，儿童死亡率持续下降，恰帕斯州更为明显。在这两个州，这种下降与急性腹泻导致的死亡率下降密切相关，也与麻疹和急性呼吸道感染的下降相关。在恰帕斯州，与死亡率下降相关性更显著的指标是疫苗接种覆盖率和识字率。在新莱昂州，相关性更强的指标是护士人数增加、有自来水供应的住所数量增加和疫苗接种覆盖率。
在分析期间，恰帕斯州和新莱昂州五岁以下儿童的死亡率有所下降。为维持或加速儿童死亡率的下降，必须继续实施当前的项目，并且在恰帕斯州及类似的州，要增加提供医疗保健的可用基础设施。
