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Dissertation
The influence of social urban environment on infant mortality in cities of Latin America
Doctor of Philosophy (Ph.D.), Drexel University
Jul 2019
DOI:
https://doi.org/10.17918/snab-q106
Abstract
The heterogenous urbanization process experienced by Latin America (LA) may have varying implications for infant mortality (IM). We quantified variability in IM rates (IMR) and in the proportion of post-neonatal deaths (PPND) across LA cities, and examined how city socioeconomic (SE), women's empowerment (WE), and demographic (population size (PS) and growth (PG)) characteristics are related to this variability. We estimated IMR and PPND for years 2014-2016 for 286 cities of 100,000 residents or more in 8 countries. We combined census-derived SE indicators into factors reflecting living conditions (LC), service provision (SP), and educational attainment in the total population (EA). WE indicators included women's labor force participation (WLFP) and women's educational attainment. We used Poisson multi-level models to estimate relative differences in IMR and PPND associated with SE and WE scores and PS and PG after accounting for healthcare access. Of the 286 cities, 200 had <500,000 inhabitants and 5 had >5 million. Overall IMR and PPND were 11.2 deaths/1,000 live births and 31%, respectively. Of the total IMR and PNND variability across cities, 57% and 67% were among cities within a country, respectively. A 1 standard deviation (SD) higher LC, SP, PG and WLFP score was associated with 14.7%, 12.1%, 5.0%, and 6.1% lower IMR, respectively. A 1SD higher PS and EA score was associated with 1.4% and 14.6% higher PPND, respectively. A 1SD higher LC score was associated with 6.6% lower PPND. Addressing city social environments may help promote infant health in cities. Key words: infant mortality, post-neonatal deaths, Latin America, urban health
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Details
- Title
- The influence of social urban environment on infant mortality in cities of Latin America
- Creators
- Ana F. Ortigoza - DU
- Contributors
- Ana Victoria Diez Roux (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- ix, 145 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Dana and David Dornsife School of Public Health; Epidemiology and Biostatistics; Drexel University
- Other Identifier
- 10379; 991014632306604721