Gender inequality, women's empowerment, and adolescent birth rates in 363 Latin American cities.

BACKGROUND: Gender inequality is high in Latin America (LA). Empowering girls and young women and reducing gender gaps has been proposed as a pathway to reduce adolescent pregnancy. We investigated the associations of urban measures of women's empowerment and gender inequality with adolescent birth rates (ABR) in 366 Latin American cities in nine countries. METHODS: We created a gender inequality index (GII) and three Women Achievement scores reflecting domains of women's empowerment (employment, education, and health care access) using censuses, surveys, and political participation data at city and sub-city levels. We used 3-level negative binomial models (sub-city-city-countries) to assess the association between the GII and scores, with ABR while accounting for other city and sub-city characteristics. RESULTS: We found within country heterogeneity in gender inequality and women's empowerment measures. The ABR was 4% higher for each 1 standard deviation (1-SD) higher GII (RR 1.04; 95%CI 1.01,1.06), 8% lower for each SD higher autonomy score (RR 0.92; 95%CI 0.86, 0.99), and 12% lower for each SD health care access score (RR 0.88; 95%CI 0.82,0.95) after adjustment for city level population size, population growth, homicide rates, and sub-city population educational attainment and living conditions scores. CONCLUSION: Our findings show the key role cities have in reducing ABR through the implementation of strategies that foster women's socioeconomic progress such as education, employment, and health care access.

Cambios recientes en la mortalidad por cáncer de próstata en Chile: estudio de tendencias en el período 1955-2001 / Recent changes in prostate cancer mortality in Chile: trends analysis from 1955 to 2001

Background: By the year 2000, prostate cancer became the second leading cause of cancer death in Chilean men of all ages and is the leading cause of cancer deaths in men of eighty years of age or older. Aim: To analyze the trends in mortality rates from prostate cancer in Chile in a fifty years series, estimating the rate of increase of such rates and their changes in time. Material and methods: A trend analysis for age standardized mortality rates was performed, using join point regression analysis, which allows estimation of the annual percent change of rates and to find significant changes in such trend. Results: Age standardized mortality rates in Chile reached their peak value in 1996, becoming apparently stable from then on. Crude rates have had a steady increase during the whole period. The trends analysis identified three different periods in the growth of the age standardized rates: a first one of slow increase in rates between 1955 and 1981 (0.9 percent annual increase), a second one of more aggressive growth starting in 1981 (2.6 percent annual increase), and a third period starting in 1996, in which rates slowly decline at an annual rate of 1 percent. Conclusions: The tendency of prostate cancer seen in Chile resembles that of industrialized countries, with an increase in its age standardized death rates that suffers a downturn by the end of the past decade. Besides early detection techniques, a substantial part of the reduction in mortality from prostate cancer could be explained by therapeutic improvements (Rev MÚd Chile 2004; 132: 579-87).