Studies
on
health
inequalities
on
developing
cities
are
scarce.
They
have
mainly
focused
on
infant
and
child
mortality
and
life
expectancy
at
birth.
Studies
of
adult
mortality
and
cause-
specific
studies
have
seldom
been
carried
out.
An
ecological
study
was
performed
in
order
to
investigate
the
relationship
between
mortality
due
to
all
causes
of
death,
infectious
diseases,
combined
illness
of
diarrhoea,
pneumonia
and
malnutrition,
external
causes,
homicides,
and
motor
vehicle
traffic
accidents,
and
socio-
environmental
conditions
in
a
developing
city,
Belo
Horizonte
in
Brazil.
Death
certificates
relating
to
1994
were
processed.
A
total
of
10,558
certificates
were
geocoded
according
to
75
geographical
areas.
The
areas
were
classified
according
to
the
income
of
the
head
of
family
(or
female
illiteracy
when
appropriate),
and
plausible
routinely
environmental
factors.
In
the
study
of
mortality
due
to
infectious
diseases,
water,
sanitation,
crowding,
and
rubbish
collection
were
tested.
Among
the
external
causes,
the
study
focused
on
homicide
and
motor
vehicle
traffic
accidents,
testing
the
effect
of
public
illumination,
crowding
and
the
average
time
for
police
response
to
a
phone
call.
Analytical
and
descriptive
techniques
were
used
in
the
study.
Mortality
rate
(MR)
ratios
were
estimated
using
random
effects
Poisson
regression.
A
high
correlation
was
found
between
socio-economic
and
environmental
variables.
These
correlated
to
the
distribution
of
mortality
rates
across
the
areas.
Shantytown
areas
(the
favelas)
presented
higher
risk
of
mortality
than
non-favela
areas.
Infectious
diseases,
homicide,
and
combined
illness
of
diarrhoea,
pneumonia
and
malnutrition
(under
5
years
old)
presented
MR
ratios
of
1.59,2.05,
1.62,
respectively.
All
of
them
presented
p-values
for
trend
<0.00.
Deaths
due
to
all
causes
presented
1.12
(p=0.04).
Adverse
socio-economic
and
environmental
conditions
are
associated
with
higher
rates
of
specific
cause
of
death.
Deprived
areas
encompass
highest
vulnerable
groups.
The
use
of
routine
data
in
developing
countries
can
be
used
to
measure
the
inequalities
in
health,
helping
build
up
more
adequate
urban
and
health
policies.
