Universidad Peruana Cayetano Heredia

Adolescent birth rates and the urban social environment in 363 Latin American cities

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dc.contributor.author Braverman-Bronstein, Ariela
dc.contributor.author Vidana-Perez, Desiree
dc.contributor.author Ortigoza, Ana F.
dc.contributor.author Baldovino-Chiquillo, Laura
dc.contributor.author Diez-Canseco Montero, Francisco
dc.contributor.author Maslowsky, Julie
dc.contributor.author Sanchez, Brisa N.
dc.contributor.author Barrientos-Gutierrez, Tonatiuh
dc.contributor.author Roux, Ana V. Diez
dc.date.accessioned 2022-11-15T23:04:37Z
dc.date.available 2022-11-15T23:04:37Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/12542
dc.description.abstract Introduction Latin America has the second-highest adolescent birth rate (ABR) worldwide. Variation between urban and rural areas and evidence linking country development to ABR points towards upstream factors in the causal pathway. We investigated variation in ABR within and between cities, and whether different features of urban social environments are associated with ABR. Methods We included 363 cities in 9 Latin American countries. We collected data on social environment at country, city and subcity levels and birth rates among adolescents (ages 15-19). We investigated variation in ABR within and between countries and cities along with associations between social environment and ABR by fitting three-level negative binomial models (subcities nested within cities nested within countries). Results The median subcity ABR was 58.5 per 1000 women 15-19 (IQR 43.0-75.3). We found significant variability in subcity ABR between countries and cities (37% of variance between countries and 47% between cities within countries). Higher homicide rates and greater population growth in cities were associated with higher ABR (rate ratio (RR) 1.09; 95% CI 1.06 to 1.12 and RR 1.02; 95% CI 1.00 to 1.04, per SD, respectively), while better living conditions and educational attainment in subcities were associated with lower ABR after accounting for other social environment characteristics (RR 0.95; 95% CI 0.92 to 0.98 and 0.78; 95% CI 0.76 to 0.79, per SD, respectively). Conclusions The large heterogeneity of ABR found within countries and cities highlights the key role urban areas have in developing local policies. Holistic interventions targeting education inequalities and living conditions are likely important to reducing ABR in cities. en_US
dc.language.iso eng
dc.publisher BMJ Publishing Group
dc.relation.ispartofseries BMJ Global Health
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adolescent en_US
dc.subject birth rates en_US
dc.subject urban social environment en_US
dc.subject Latin America en_US
dc.subject city en_US
dc.title Adolescent birth rates and the urban social environment in 363 Latin American cities en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1136/bmjgh-2022-009737
dc.relation.issn 2059-7908


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