Social inequalities in child development: Analysis of Low-Birth-Weight trends in Brazil, 2010-2020

Abstract

AbstractIntroductionGlobally, low birth weight (LBW) is prevalent in low-income countries. Although the economic assessment of interventions to reduce this burden is essential to guide health policies, research that illustrates the magnitude of LBW by country and region as a way to support the design of public policies is still relatively scarce.ObjectiveTo analyze the temporal trend of fetal growth of newborns in Brazil, in the period from 2010 to 2020.MethodsA time series study, whose data source was the Live Births Information System (SINASC), of the Department of Information and Informatics of the Unified Health System (DATASUS), linked to the Ministry of Health, Brazil. The Prais-Winsten linear model was applied to analyse the annual proportions of LBW. The annual percentage changes (APC) and its respective 95% confidence intervals (95%CI) were calculated. To visualize the dynamics of evolution in each Federation Unit (FU), prevalence rate averages of LBW were calculated and displayed on thematic maps.ResultsBetween 2010 and 2020, there was a trend toward stabilization of the increasing proportions of low birth weight in the North, Northeast and Centre-West regions. In Brazil and the other regions these tendencies remained stable.ConclusionTo improve the living conditions of the population, public policies and actions aimed at reducing social inequalities and inequity is health are necessary, such as strengthening the Unified Health System (SUS), income transfer programs, quota policies for vulnerable groups, and gender to improve access to education for women and the labour sector.WHAT IS ALREADY KNOWN ON THIS TOPICIn Brazil, health social inequalities have a historical explanation due to the socio-economic and political system that encourages a competitive economic development model.Improved access to education and health care has reduced the risk of low birth weight (LBW) in all Brazilian regions in recent years.Differences in trends in LBW rates and associated factors within and between regions of Brazil.WHAT THIS STUDY ADDSThe study provides relevant information on the trend of LBW rates in recent years and makes a comparison between regions and the country as a whole.There were differences in the trend of LBW between Brazilian regions, with an increasing trend in the North, Northeast and Central-West regions, but on the other hand, the South and Southeast regions remain stationary.Stationary trend in the prevalence of BPN in Brazil in recent years (2010-2020), findings that should be associated with the improvement in the living conditions of the population.HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICYIt can be taken into account when building public policies aimed at improving the living conditions of the population public policies and actions aimed at reducing health inequalities and inequities are needed.