Infant mortality in the Brazil of the 21st century: dilemma of territorial development and regional health inequalities

Abstract

Infant mortality is one of the best indicators to measure territorial disparities, because it is dependent on the social and living conditions of the population. Few studies, however, have proposed a spatial assessment of this indicator for all of Brazil, despite its geographical nature. The aim of this paper is to present a geographic study of infant mortality for the whole country and to outline some territorial and health processes associated with an indicator. The study was done for the municipalities and with data collected from 2013 to 2017. The infant mortality rate (IMR) was calculated between live births and infant deaths and estimated using the empirical Bayesian method. Subsequently, the Moran Global and Local Index was applied to find high and low rate spatial clusters. From these groupings it was possible to establish and classify ten territorial situations (regions) with characteristics for the implementation of prevention and control actions. The results show a fragmented and unequal Brazil, with high IMR in the municipalities of the northern border, the interior of the Legal Amazon and the northeast. There is still a huge transition area between a "Northern Brazil" and a "Southern Brazil", the latter being marked by spatial concentrations of the lowest IMT and better indicators of social and health deprivation.