Infant mortality rates according to socioeconomic status in a Brazilian city

Objective Data from municipal databases can be used to plan interventions a imed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geo economic classification using routinely collected municipal data, Methods All live births (total of 42,381) and infant deaths (total of 731) that occurred between 1994 and 1998 in Ribeirao Preto, Brazil, were conside red. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. Results The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribe irao Preto from 1994 to 1998 (chi-square for trend, p <0.05), These rates w ere inversely correlated with the distribution of lower salaries in the geo economic areas (less than 5 minimum wages per family head), in particular t he post-neonatal mortality rate (chi-square for trend, p<0.05). Finally, th e poor area showed a steady increase in excess infant mortality. Conclusions The results indicate that infant mortality rates are associated with social inequality and can be monitored using municipal databases. The findings also suggest an increase in the impact of social inequality on in fant health in Ribeirao Preto, especially in the poor area. The monitoring of health inequalities using municipal databases may be an increasingly mor e useful tool given the continuous decentralization of health management at the municipal level in Brazil.