Social inequality possibly related to fetal mortality in Argentina, 2007-2016

Abstract

INTRODUCTION: There is an insufficient number of studies on the relation between fetal mortality and hostile social conditions at department or geographic area (GA) level. The objective of this study was to evaluate and measure the inequality in fetal mortality according to the different GA. METHODS: An ecological descriptive study was conducted. The units analyzed were the 525 GA of Argentina during 2007- 2016. A principal component analysis of selected variables from the National Population, Household and Housing Census of 2010 was carried out; then a socioeconomic indicator was constructed, which was used to determine these areas. Different indices were calculated by means of Poisson regression analysis. The slope index of inequality (SII) and the Kunst and Mackenbach relative index of inequality (RIIKM) were obtained, and the fetal mortality ratio (FMR) was estimated for each level of the socioeconomic indicator. RESULTS: The RIIKM varied from 1.8 to 1.4 for the bienniums 2007/08-2015/16, estimating the highest FMR for the stratum of very unfavorable socioeconomic situation, and a similar behavior was reflected in the SII. DISCUSSION: The FMR is greater for the strata of very unfavorable socioeconomic situation. The gap between the extremes increased again towards the last biennium. In the GA with a very unfavorable situation, the FMR  increased in the last biennium in comparison with the previous one, and it decreased for the GA with a very favorable situation.