[Inequities in health: socio-demographic and spatial analysis of breast cancer in women from Córdoba, Argentina].
OBJECTIVE
To identify sociodemographic determinants associated with the spatial distribution of the breast cancer incidence in the province of Córdoba, Argentina, in order to reveal underlying social inequities.


METHODS
An ecological study was developed in Córdoba (26 counties as geographical units of analysis). The spatial autocorrelation of the crude and standardised incidence rates of breast cancer, and the sociodemographic indicators of urbanization, fertility and population ageing were estimated using Moran's index. These variables were entered into a Geographic Information System for mapping. Poisson multilevel regression models were adjusted, establishing the breast cancer incidence rates as the response variable, and by selecting sociodemographic indicators as covariables and the percentage of households with unmet basic needs as adjustment variables.


RESULTS
In Córdoba, Argentina, a non-random pattern in the spatial distribution of breast cancer incidence rates and in certain sociodemographic indicators was found. The mean increase in annual urban population was inversely associated with breast cancer, whereas the proportion of households with unmet basic needs was directly associated with this cancer.


CONCLUSIONS
Our results define social inequity scenarios that partially explain the geographical differentials in the breast cancer burden in Córdoba, Argentina. Women residing in socioeconomically disadvantaged households and in less urbanized areas merit special attention in future studies and in breast cancer public health activities.
Centro de Investigaciones y Estudios sobre Cultura y Sociedad (CIECS), Universidad Nacional de Córdoba, CONICET, Córdoba, Argentina.
Natalia
N
Tumas
Instituto de Investigaciones en Ciencias de la Salud (INICSA), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, CONICET, Córdoba, Argentina; Cátedra de Estadística y Bioestadística, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, CONICET, Córdoba, Argentina.
Sonia Alejandra
SA
Pou
Instituto de Investigaciones en Ciencias de la Salud (INICSA), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, CONICET, Córdoba, Argentina; Cátedra de Estadística y Bioestadística, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, CONICET, Córdoba, Argentina. Electronic address: pdiaz@fcm.unc.edu.ar.
María Del Pilar
MDP
Díaz
D000328:Adult; D001118:Argentina / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D064890:Social Determinants of Health; D062206:Spatial Analysis
Análisis espacial; Argentina; Breast cancer; Cáncer de mama; Demografía; Demography; Determinantes sociales de la salud; Health inequity; Inequidad en salud; Social determinants of health; Spatial analysis