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[1991年和2000年巴西塞阿拉州的婴儿死亡率及社会人口状况]

[Infant mortality and sociodemographic conditions in Ceará, Brazil, 1991 and 2000].

作者信息

Bezerra Filho José Gomes, Pontes Lígia Regina Franco, Miná Daniel de Lima, Barreto Maurício Lima

机构信息

Departamento de Saúde Comunitária, Universidade Federal do Ceará, Fortaleza, CE, Brasil.

出版信息

Rev Saude Publica. 2007 Dec;41(6):1023-31. doi: 10.1590/s0034-89102007000600018.

Abstract

OBJECTIVE

To assess ecological models to describe infant mortality rate in Ceara (Northeastern Brazil) in two different periods of time.

METHODS

This was a cross-sectional ecologic study of two years, 1991 and 2000, using non-matching information per municipalities. Estimates on the infant mortality rate of the Instituto de Pesquisas Econômicas Aplicadas (Institute of Applied Economic Research) have been used. For the remaining indicators different sources of the System of Health Information were used. The main risk factors were assessed using multiple linear regression.

RESULTS

In 1991, the variables that predicted infant mortality rate (R2=0.3575) were: small houses (beta=0.0043; rho=0.010), proportion of inhabitants with tap water in the household (beta=-0.0029; rho=0.024), urbanization rate (beta=0.0032; rho=0.004), fecundity rate (beta=0.0351; rho=0.024), the proportion of children working at 10-14 years (beta=0.0049; rho=0.017), proportion of families with income < 1/2 minimum wage (beta=0.0056; rho=0.000), that can read and write (beta=-0.0062; rho=0.031). In the year 2000, the following possible determinants were identified (R2=0.3236): the proportion of children <2 years of age with malnutrition (beta=0.0064; rho=0.024), proportion of households with adequate sanitation (beta=-0.0024; rho=0.010), proportion of women who could read and write (beta=-0.0068; rho=0.044), expenses on health human resources regarding total health expenses (beta=-0.0024; rho=0.027), proportion of the value of the vegetal production in relation to the total of the state (beta=-0.1090; rho=0.001), intensity of poverty (beta=0.0065; rho=0.002), and ageing index (beta=-0.0100; rho=0.006).

CONCLUSIONS

Although the variables have not been exactly the same for the evaluated period, determiners of infant mortality have been changing, except for indicators of education, income and sanitation. The overall decrease in fecundity led to a reduction in its discriminating power, and it was replaced by the ageing index. Another tendency observed was the replace of several demographic variables by health care indicators.

摘要

目的

评估生态模型,以描述巴西东北部塞阿拉州在两个不同时期的婴儿死亡率。

方法

这是一项针对1991年和2000年这两年的横断面生态研究,使用各城市不匹配的信息。采用了应用经济研究所对婴儿死亡率的估计数据。对于其余指标,则使用了卫生信息系统的不同来源数据。主要风险因素通过多元线性回归进行评估。

结果

1991年,预测婴儿死亡率(R2 = 0.3575)的变量有:小房屋(β = 0.0043;相关系数 = 0.010)、家庭中有自来水的居民比例(β = -0.0029;相关系数 = 0.024)、城市化率(β = 0.0032;相关系数 = 0.004)、生育率(β = 0.0351;相关系数 = 0.024)、10至14岁工作儿童的比例(β = 0.0049;相关系数 = 0.017)、收入低于最低工资一半的家庭比例(β = 0.0056;相关系数 = 0.000)、识字率(β = -0.0062;相关系数 = 0.031)。2000年,确定了以下可能的决定因素(R2 = 0.3236):2岁以下营养不良儿童的比例(β = 0.0064;相关系数 = 0.024)、卫生设施充足的家庭比例(β = -0.0024;相关系数 = 0.010)、识字妇女的比例(β = -0.0068;相关系数 = 0.044)、卫生人力资源费用占卫生总费用的比例(β = -0.0024;相关系数 = 0.027)、植物生产价值占该州总值的比例(β = -0.1090;相关系数 = 0.001)、贫困强度(β = 0.0065;相关系数 = 0.002)和老龄化指数(β = -0.0100;相关系数 = 0.006)。

结论

尽管评估期间的变量并不完全相同,但除了教育、收入和卫生设施指标外,婴儿死亡率的决定因素一直在变化。生育率的总体下降导致其区分能力降低,取而代之的是老龄化指数。观察到的另一个趋势是,几个人口统计学变量被医疗保健指标所取代。

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