Widening ethnic disparities in infant mortality in southern Brazil: comparison of 3 birth cohorts.
OBJECTIVE
We analyzed trends in mortality among infants born to White and to Black or mixed-race women in 3 population-based cohorts representing all births in 1982, 1993, and 2004 in Pelotas, southern Brazil.


METHODS
Births were assessed during daily visits to all maternity hospitals. Maternal skin color was classified by the interviewers as White or Black or multi-racial. We used logistic regression to adjust for socioeconomic, demographic, and health services variables.


RESULTS
The mortality rate among infants born to White mothers declined from 30.4 per 1000 live births in 1982 to 13.9 per 1000 in 2004, compared with 53.8 per 1000 to 30.4 per 1000 among those born to Black and mixed-race mothers. Differences for neonatal mortality were even more marked, with reductions of 47% and 11% for infants born to White and Black or mixed-race women, respectively. Adjusted analyses showed that ethnic group differences in neonatal and infant mortality were partly explained by differences in poverty and prenatal care.


CONCLUSIONS
Over a 22-year period, improvements in health indicators were greater for infants born to White women than for other infants. The widening racial gap requires special attention from policymakers.
Matijasevich
Alicia
A
Post-Graduation Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Brazil. amatija@yahoo.com
Victora
Cesar G
CG
Barros
Aluísio J D
AJ
Santos
Iná S
IS
Marco
Paula L
PL
Albernaz
Elaine P
EP
Barros
Fernando C
FC
D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006801:Humans; D007226:Infant Mortality / Q000208:ethnology*; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D008429:Maternal Welfare / Q000208:ethnology; D011157:Population Dynamics; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors