Modest advances, persistent inequalities: child mortality in Brazil from 2010 to 2022
DOI:
https://doi.org/10.11606/s1518-8787.2025059006452Keywords:
Infant Mortality, Child Mortality, Socioeconomic Disparities in Health, BrazilAbstract
OBJECTIVE: To analyze the evolution of socioeconomic and regional inequalities in mortality among children under five years of age in Brazil between 2010 and 2022. METHODS: Data from 37,639,196 live births (LB) and 563,711 deaths among children under five years during the period were analyzed. Mortality rates for infants (<one year-old, IMR) and children aged one to four years were calculated. For inequality analysis, municipalities were grouped according to deciles of the 2010 Municipal Human Development Index (M-HDI). The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were calculated. The excess mortality was estimated by applying the mortality rates observed in the highest M-HDI decile to the other deciles. The spatial distribution of deaths was analyzed according to the country’s microregions. RESULTS: The IMR decreased from 13.0 to 12.7 per thousand LB between 2010 and 2022, while mortality among children aged one to four years remained stable at 2.5 per thousand LB in 2010-2022. There was only a slight reduction in inequalities, with the SII oscillating from -5.63 to -4.91 in IMR and from -2.42 to -1.71 in mortality among children aged one to four years between 2010-2022. In 2022, municipalities with lower M-HDI had mortality rates 49.0% and 93.0% higher than those with higher M-HDI in IMR and mortality among children aged one to four years, respectively. Inequalities in IMR were more pronounced in nutritional, metabolic, and endocrine diseases, where mortality was four times higher in municipalities with lower M-HDI. There was an excess of 76,832 child deaths in Brazil between 2010-2022. In 2022, 42.2% of the microregions in the North were among the top 100 with the highest IMR, compared to only 3.2% in the South. CONCLUSIONS: There was a slight reduction in child mortality, but significant socioeconomic and regional inequalities persisted in Brazil.
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