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Unacceptable persistence of territorial inequalities in avoidable under-five mortality in Colombia between 2000 and 2019: a multilevel approach.
Rojas-Botero, M L; Fernández-Niño, J A; Borrero-Ramírez, Y E.
Afiliação
  • Rojas-Botero ML; Universidad de Antioquia. Facultad Nacional de Salud Pública. Medellín, Colombia.
  • Fernández-Niño JA; Johns Hopkins Bloomberg School of Public Health. Baltimore MD, USA; Universidad Del Norte, Barranquilla, Colombia. Electronic address: jferna53@jhu.edu.
  • Borrero-Ramírez YE; Universidad de Antioquia. Facultad Nacional de Salud Pública. Medellín, Colombia.
Public Health ; 213: 189-197, 2022 Dec.
Article em En | MEDLINE | ID: mdl-36446150
OBJECTIVES: This study aimed at evaluating territorial inequalities in avoidable mortality in children under 5 years of age in Colombia between 2000 and 2019. STUDY DESIGN: This was an ecological study. METHODS: An ecological, longitudinal, multigroup study was conducted using secondary sources. Because of the hierarchical structure of the data, the effect of territorial characteristics on the count of avoidable under-five deaths was estimated using a three-level negative binomial regression model with random intercepts for municipality and fixed intercepts for time and departments. RESULTS: Between 2000 and 2019, there were 216,809 avoidable under-five deaths in Colombia (91.3% of all registered deaths of children under 5 years of age). A total of 1117 municipalities located in 33 departments were analyzed over five 4-year periods. Ecological relationships were found between avoidable under-five mortality and the percentage of adolescent births, female illiteracy, and multidimensional poverty at the municipal level (standardized mortality ratio: 1.43 95% confidence interval: 1.33-1.54 for the group with the highest level vs the group with the lowest level of poverty). Furthermore, multidimensional poverty was a confounding factor for the association between the percentage of the population living in rural areas and avoidable child mortality. CONCLUSIONS: Systematic and avoidable gaps were observed in mortality in children aged under 5 years in Colombia, where the territory constitutes an axis of inequality. Implementing strategies and programs that contribute to improving the conditions of women and socio-economic conditions in the territories should be a priority.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pobreza Tipo de estudo: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality / Patient_preference Limite: Adolescent / Child / Child, preschool / Female / Humans País/Região como assunto: America do sul / Colombia Idioma: En Revista: Public Health Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Holanda
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pobreza Tipo de estudo: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality / Patient_preference Limite: Adolescent / Child / Child, preschool / Female / Humans País/Região como assunto: America do sul / Colombia Idioma: En Revista: Public Health Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Holanda