Andrade Carla Lourenço Tavares de, Szwarcwald Célia Landmann, Gama Silvana Granado Nogueira da, Leal Maria do Carmo
Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Cad Saude Publica. 2004;20 Suppl 1:S44-51. doi: 10.1590/s0102-311x2004000700005. Epub 2004 May 20.
Socioeconomic inequalities in early infant mortality have been evidenced in Brazil, with a greater mortality risk associated with the mother's socioeconomic status (SES). The aim of this paper is to identify socioeconomic inequalities in relation to low birth weight and perinatal mortality in the City of Rio de Janeiro, Brazil, discussing the appropriateness of the main health inequality indexes proposed in the international literature. As the information source, we use data collected in a survey of approximately 10,000 mothers selected for interview within 48 hours after delivery in public and private hospitals in the city. Using educational level and head of household's income as indicators of SES, as well as population attributable risk and slope index of inequality as health inequality measures, the results show a steep socioeconomic gradient in the proportion of low birth weight, and especially in the perinatal mortality rate. The persistent association between socioeconomic indicators and adverse results in pregnancy indicates (at least partially) the health system's inefficacy in diminishing perinatal health inequalities in Rio de Janeiro.
巴西已证实婴儿早期死亡率存在社会经济不平等现象，母亲的社会经济地位（SES）与更高的死亡风险相关。本文旨在确定巴西里约热内卢市低出生体重和围产期死亡率方面的社会经济不平等情况，并讨论国际文献中提出的主要健康不平等指数的适用性。作为信息来源，我们使用了对该市公立和私立医院分娩后48小时内选取的约10,000名母亲进行访谈的调查所收集的数据。以教育程度和户主收入作为社会经济地位指标，以及以人群归因风险和不平等斜率指数作为健康不平等衡量指标，结果显示低出生体重比例，尤其是围产期死亡率存在明显的社会经济梯度。社会经济指标与妊娠不良结果之间的持续关联表明（至少部分表明）里约热内卢卫生系统在减少围产期健康不平等方面效率低下。
