The influence of the Great Recession on perinatal health-an ecological study on the trend changes and regional differences in Portugal

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Teresa Isabel Da Costa Leão

    Autor

  • José Henrique Dias Pinto De Barros

    Autor

Participantes de fora da FMUP

  • Doetsch, JN
  • Almendra, R
  • Severo, M
  • Teixeira, R
  • Marques, S
  • Pilot, E
  • Krafft, T

Unidades de investigação

Abstract

Background Few studies examine the relationship between socioeconomic factors and trends in mortality in high -income European countries. Due to the lack of regional-level data, most recent studies on social inequality in Portugal do not investigate regional differences. This study analyses time trends and regional disparities in the evolution of perinatal mortality (PMR) and infant mortality (IMR) associated with demographic and socioeconomic indicators following Portugal's 2008 economic and financial crisis. Methods Associations were assessed using generalised linear models. A Poisson joinpoint regression model was applied to identify relevant PMR and IMR changes between 2000 and 2018. Country regional disparities were ana-lysed using Mixed Effect Multilevel models. Findings IMR and PMR significantly decreased in the pre-crisis period but not in the post-crisis period. The significant differences between regions in IMR and PMR in 2000 were followed by a different evolution of regional IMR after 2008. PMR and IMR were not significantly associated with socioeconomic indicators. A significant positive association with maternal age at first birth was identified. Interpretation Results confirm the influence of the crisis on PMR and IMR trends in Portugal, taking into account recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility, and stagnation of IMR and PMR. Regional inequalities confirm the internal variability of the crisis influence and persistent spatial inequalities affecting IMR patterns. Funding FCT, under the Institute of Public Health of the University of Porto (ISPUP)-EPIUnit (UIDB/04750/2020) and ITR (LA/P/0064/2020), Maastricht University's external PhD programme under the Care and Public Health Research Institute (CAPHRI), and the RECAP preterm project (grant agreement no 733280).Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Dados da publicação

ISSN/ISSNe:
2666-7762, 2666-7762

Lancet Regional Health-Europe  ELSEVIER

Tipo:
Article
Páginas:
-
Link para outro recurso:
www.scopus.com

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Keywords

  • Great Recession; Infant mortality; Perinatal mortality; Socioeconomic factors; Mortality trends

Financiamento

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