Gonçalves Annelise C, Costa Maria da Conceição N, Paim Jairnilson S, da Silva Ligia Maria Vieira, Braga José Ueleres, Barreto Mauricio
Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Instituto de Saude Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil.
Rev Bras Epidemiol. 2013 Sep;16(3):682-91. doi: 10.1590/s1415-790x2013000300012.
To evaluate the association between the spatial distribution of neonatal mortality and living conditions, and to analyze trends in the social inequalities, related to this mortality, in Salvador, Bahia, Brazil, 2000 - 2006.
The city's Information Zones, the unit of analysis used in this study, were grouped into strata reflecting high, intermediate, low and very low living conditions, based on a living conditions index (LCI). Neonatal mortality rates were calculated for each stratum. Spearman's correlation, linear regression and relative risks were used in the data analysis.
Neonatal mortality in Salvador was found to be associated with living conditions, with risks of 53, 56 and 59% greater, respectively, in the intermediate, low and very low strata, when compared to the high living conditions stratum. Only the intermediate living conditions stratum shows a significant decline in neonatal mortality (β = -0.93; p = 0.039). In the stratum of high living conditions, it was observed a stagnation of this mortality.
Poorer living conditions were associated to higher risks of neonatal mortality. The slight decline in social inequalities, found in neonatal mortality, was due to a decline in the intermediate living conditions stratum. Although dependent on the access to quality healthcare services and life support technologies, a more consistent reduction in the neonatal mortality and its associated inequalities will only be achieved when broader-reaching public policies are implemented, improving the living conditions, and mainly focusing on priority groups.
评估巴西巴伊亚州萨尔瓦多市2000 - 2006年新生儿死亡率的空间分布与生活条件之间的关联，并分析与此死亡率相关的社会不平等趋势。
本研究采用的分析单位为该市的信息区，根据生活条件指数（LCI）将其分为反映高、中、低和极低生活条件的层次。计算每个层次的新生儿死亡率。数据分析采用斯皮尔曼相关性分析、线性回归分析和相对风险分析。
发现萨尔瓦多市的新生儿死亡率与生活条件相关，与高生活条件层次相比，中等、低和极低生活条件层次的风险分别高出53%、56%和59%。只有中等生活条件层次的新生儿死亡率显著下降（β = -0.93；p = 0.039）。在高生活条件层次中，观察到该死亡率停滞不前。
较差的生活条件与较高的新生儿死亡风险相关。新生儿死亡率方面发现的社会不平等略有下降，是由于中等生活条件层次的下降。尽管依赖于获得优质医疗服务和生命支持技术，但只有实施更广泛的公共政策，改善生活条件，并主要关注优先群体，才能实现新生儿死亡率及其相关不平等的更持续降低。
