Bezerra Filho José Gomes, Kerr Lígia Regina Franco Sansigolo, Miná Daniel de Lima, Barreto Maurício Lima
Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil.
Cad Saude Publica. 2007 May;23(5):1173-85. doi: 10.1590/s0102-311x2007000500019.
The geographic distribution of health problems and its relationship to potential risk factors has opened a vast field for epidemiological research. The present study aims to identify spatial distribution patterns for the neonatal and post-neonatal components of the infant mortality rate (IMR) in Ceará State, Brazil, and discuss the main socioeconomic, demographic, and healthcare factors contributing to the spatial dependence of these components. This cross-sectional ecological study uses multiple linear regression, in which spatial analysis of the components was obtained through the Moran index. Prenatal, childbirth, and neonatal care as well as improved income distribution are decisive for survival in the first month of life, while other factors related to nutrition, immunization, sanitation, education, and economic status are possible determinants of post-neonatal mortality. Selective healthcare measures are known to play a decisive role in decreasing the IMR. However, structural and inter-sector changes generate the sustainability needed to maintain this indicator on the same level as in developed countries.
健康问题的地理分布及其与潜在风险因素的关系为流行病学研究开辟了广阔领域。本研究旨在确定巴西塞阿拉州婴儿死亡率(IMR)中新生儿和新生儿后期部分的空间分布模式,并讨论导致这些部分空间依赖性的主要社会经济、人口和医疗因素。这项横断面生态研究采用多元线性回归,其中各部分的空间分析通过莫兰指数获得。产前、分娩和新生儿护理以及收入分配的改善对生命第一个月的存活至关重要,而与营养、免疫、卫生、教育和经济状况相关的其他因素可能是新生儿后期死亡率的决定因素。众所周知,选择性医疗措施在降低婴儿死亡率方面起着决定性作用。然而,结构性和部门间的变革产生了将这一指标维持在与发达国家相同水平所需的可持续性。