Desigualdades sociales en la mortalidad de niños menores de cinco años: revisión sistemática
Social inequalities in under-five mortality: a systematic review
DOI:
https://doi.org/10.15446/rsap.v22n2.86964Palavras-chave:
Determinantes sociales de la salud, estratificadores de equidad, disparidades en el estado de salud, mortalidad del niño, revisión sistemática (es)Social determinants of health, equity stratifiers, health status disparities, child mortality, systematic review (en)
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Objetivo Identificar las características de los estudios sobre desigualdades sociales, en la mortalidad de niños menores de cinco años; sus perspectivas teóricas, ejes de desigualdad, métodos y resultados.
Método Revisión sistemática de la literatura. Se consultaron cuatro bases de datos electrónicas y Google Scholar; se incluyeron estudios entre 2010 y 2018.
Resultados Se analizaron 126 artículos. En el 62,7%, se estudió el territorio como eje de desigualdad, seguido por los determinantes socioeconómicos (27,8%). La mortalidad neonatal, infantil y en la niñez fue analizada en el 19,0%, 49,2% y 32,3%, respectivamente. Predominaron los estudios ecológicos (62,7%) y longitudinales (50,0%). Se encontró una disminución considerable en las tasas de mortalidad; sin embargo, el descenso no fue homogéneo entre subpoblaciones.
Conclusiones La literatura reporta una marcada disminución de la mortalidad en niños menores de cinco años; no obstante, las brechas entre distintos ejes de desigualdad continúan y en algunos lugares se han incrementado. Las brechas entre los estratificadores variaron de acuerdo con el tiempo, lugar, eje de desigualdad y tipo
de mortalidad analizada.
Objective To identify the characteristics of the published studies on social inequalities in under-five mortality, their theoretical perspectives, axes of inequality, methods and results.
Method We carried out a systematic literature review. We consulted four electronic databases and Google Scholar, for studies published between 2010 and 2018.
Results We analyzed 126 articles. In 62.7%, territory was studied as the axis of inequality, followed by socioeconomic determinants (27.8%). Neonatal, infant and under-five mortality was analyzed as an output in health in 19.0%, 49.2% and 32.3%, respectively. It predominated ecological (62.7%) and longitudinal (50.0%) studies. Significant reductions in mortality rates were found, however, the decline was not homogeneous among subpopulations.
Conclusions The literature reports a marked decrease in under-five mortality; however, the gaps between different axes of inequality continue and in some cases they have increased. Gaps varied according to time, place, axis of inequality and type of mortality analyzed.
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