Spatial analysis of inequalities in fetal and infant mortality due to avoidable causes.

OBJECTIVES: to analyze social inequalities in spatial distribution of fetal and infant mortality by avoidable causes and identify the areas of greater risk of occurrence. METHODS: avoidable deaths of fetal and infant residents of Recife/Brazil were studied. The rates of avoidable fetal and infant mortality were calculated for two five-year periods, 2006-2010 and 2011-2015. The scan statistics was used for spatial analysis and related to the social deprivation index. RESULTS: out of the total 2,210 fetal deaths, 80% were preventable. Avoidable fetal mortality rates increased by 8.1% in the five-year periods. Of the 2,846 infant deaths, 74% were avoidable, and the infant mortality rate reduced by 0.13%. CONCLUSIONS: in the spatial analysis, were identified clusters with higher risk for deaths. The social deprivation index showed sensibility with areas of worse living conditions.

Spatial analysis of inequalities in fetal and infant mortality due to avoidable causes / Análisis espacial de las desigualdades en la mortalidad fetal e infantil debido a causas evitables / Análise espacial das desigualdades na mortalidade fetal e infantil por causas evitáveis

ABSTRACT Objectives: to analyze social inequalities in spatial distribution of fetal and infant mortality by avoidable causes and identify the areas of greater risk of occurrence. Methods: avoidable deaths of fetal and infant residents of Recife/Brazil were studied. The rates of avoidable fetal and infant mortality were calculated for two five-year periods, 2006-2010 and 2011-2015. The scan statistics was used for spatial analysis and related to the social deprivation index. Results: out of the total 2,210 fetal deaths, 80% were preventable. Avoidable fetal mortality rates increased by 8.1% in the five-year periods. Of the 2,846 infant deaths, 74% were avoidable, and the infant mortality rate reduced by 0.13%. Conclusions: in the spatial analysis, were identified clusters with higher risk for deaths. The social deprivation index showed sensibility with areas of worse living conditions.

RESUMEN Objetivos: analizar las desigualdades sociales en la distribución espacial de la mortalidad fetal e infantil por causas prevenibles e identificar las áreas de mayor riesgo de ocurrencia. Métodos: se estudiaron las muertes fetales e infantiles prevenibles de residentes de Recife/Brasil. Se calcularon las tasas de mortalidad fetal e infantil prevenibles para dos períodos de cinco años, 2006-2010 y 2011-2015. Para el análisis espacial, utilizamos las estadísticas de escaneo y las relacionamos con el índice de privación social. Resultados: de las 2,210 muertes fetales, el 80% era prevenible y la tasa de mortalidad fetal aumentó un 8,1% en los períodos de cinco años. De las 2,846 muertes infantiles, el 74% era prevenible, y la tasa de mortalidad se redujo en 0,13%. Conclusiones: en el análisis espacial, se identificaron grupos con mayor riesgo de muerte. El índice de privación social mostró sensibilidad con las áreas con las peores condiciones de vida.

RESUMO Objetivos: analisar as desigualdades sociais na distribuição espacial da mortalidade fetal e infantil por causas evitáveis e identificar as áreas de maior risco de ocorrência. Métodos: foram estudados os óbitos fetais e infantis evitáveis de residentes do Recife/Brasil. As taxas de mortalidade fetal evitável e mortalidade infantil evitável foram calculadas para dois períodos de cinco anos, 2006-2010 e 2011-2015. A estatística scan foi utilizada para análise espacial e relacionada ao índice de privação social. Resultados: do total de 2.210 óbitos fetais, 80% foram evitáveis, e a taxa de mortalidade fetal aumentou 8,1% nos períodos de cinco anos. Dos 2.846 óbitos infantis, 74% foram considerados evitáveis e a taxa de mortalidade infantil reduziu em 0,13%. Conclusões: a análise espacial identificou clusters com risco aumentado de morte. O índice de privação social mostrou sensibilidade com as áreas de pior condição de vida.

[Social and environmental vulnerability, flooding and repercussions on public health in underdeveloped regions: the case of the state of Alagoas, Brazil]. / Vulnerabilidade socioambiental, inundações e repercussões na Saúde em regiões periféricas: o caso de Alagoas, Brasil.

The scope of this article is to analyze the social and environmental vulnerability of the population affected by disasters adopting the floods that occurred in the State of Alagoas in 2010 as a case study. For this, research was conducted in the Scielo and Medline databases as well as books, dissertations and theses. In addition, newspaper articles published in the local and national press about these floods were located and examined. A visit was made to some of the individuals who were affected by the flood and subsequently housed in the Santa Fé Prison Colony located in the municipality of União dos Palmares in the State of Alagoas. Among other aspects, the vulnerability is a consequence of the precarious living conditions of this population. However, even among the vulnerable there are some groups that are even more vulnerable without any possibility of changing a situation of chronic repetition of the disaster, perpetuating the vicious cycle of poverty and precarious living conditions.

Vulnerabilidade socioambiental, inundações e repercussões na Saúde em regiões periféricas: o caso de Alagoas, Brasil / Social and environmental vulnerability, flooding and repercussions on public health in underdeveloped regions: the case of the state of Alagoas, Brazil

Este artigo tem por objetivo analisar a vulnerabilidade socioambiental das populações afetadas por desastres, adotando como estudo de caso as inundações ocorridas no Estado de Alagoas, Brasil, em 2010. Para tanto, foram pesquisadas as bases de dados Scielo e Medline, livros, dissertações e teses. Além disso, foram levantadas e analisadas matérias publicadas na imprensa local e nacional sobre essas inundações. Realizou-se também uma visita à Colônia Prisional Santa Fé, localizada no município de União dos Palmares (AL), onde se encontra abrigada parte da população afetada por inundações. A vulnerabilidade resulta, entre outras coisas, de condições de vida precárias dessa população. Mas, mesmo entre os vulneráveis há alguns grupos que se tornam ainda mais vulneráveis, vivenciando sem possibilidades de mudança uma situação de cronificação do desastre, de perpetuação do ciclo vicioso da pobreza e das precárias condições de vida.

The scope of this article is to analyze the social and environmental vulnerability of the population affected by disasters adopting the floods that occurred in the State of Alagoas in 2010 as a case study. For this, research was conducted in the Scielo and Medline databases as well as books, dissertations and theses. In addition, newspaper articles published in the local and national press about these floods were located and examined. A visit was made to some of the individuals who were affected by the flood and subsequently housed in the Santa Fé Prison Colony located in the municipality of União dos Palmares in the State of Alagoas. Among other aspects, the vulnerability is a consequence of the precarious living conditions of this population. However, even among the vulnerable there are some groups that are even more vulnerable without any possibility of changing a situation of chronic repetition of the disaster, perpetuating the vicious cycle of poverty and precarious living conditions.