Embarazo Adolescente en Chile: Una mirada a la desigualdad sociodemográfica comunal

Abstract

Introduction and objectives: Teen pregnancy is a worldwide public health problem. In Chile, its association to social determinants and inequality has not been well studied. Our objective was to evaluate teen pregnancy distribution, quantify inequality and analyze associated socioeconomic, demographic and municipal health factors, by Chilean communes. Methods: We studied the percentage of live births from woman 10 to 19 years old and adolescent fertility rate, from 2008 to 2012, in the 345 communes of Chile. We measured inequality through four indicators: Gini, Theil, Variation coefficient and 90/10 ratio. Using panel data models, we evaluated association of adolescent fertility rate to communes' characteristics. Results: We observed a decrease in the communal teen pregnancy median, with a mild raise in inequality indicators. Adolescent fertility was heavily associated to a greater dependence in municipal resources to a redistribution fund (p<0.01), less expense in municipal healthcare per capita (p<0.05) and less emergency contraception consultations rate (p<0.05 or p<0.1, depending on the model built). In some models, we found a direct association to poverty (p<0.01) and years of life lost (YLL) (p<0.01), and indirect to average schooling years (p<0.05). Conclusions: Association found to socioeconomic and municipal health characteristics allows proposing that inequality in teen pregnancy by communes in Chile will continue increasing, deepening inequality of opportunity and intergenerational transmission of poverty.