Relationship between income inequality, socioeconomic development, vulnerability index, and maternal mortality in Brazil, 2017

BACKGROUND: Public health recognizes that health conditions depend on factors related to the development patterns income distribution, degree of poverty, working conditions, among other social determinants. The objective of this study was to analyze the association of maternal mortality with the Human Development Index (HDI), Gini Index, Income per capita, and the Social Vulnerability. METHOD: The study analyzed the relationship between MMR and socioeconomic indicators in the 26 federative units and the Federal District of Brazil, in 2017. The socioeconomic indicators used in the study were: HDI, Gini Index, Income per capita, and SVI. Crude and adjusted linear regression were performed between maternal mortality and socioeconomic indicators. RESULTS: When analyzing which socioeconomic determinants that are related to maternal mortality ratio rates, a higher per capita income positive effect was observed for lower MMR (β = − 150.8; CI 95% -289.9 to − 11.7; r(2) = 0.17; p = 0.035), as well as a trend of higher MMR in relation to the SVI (β = 97.7; CI 95% -12.2 to 207.6; r(2) = 0.12; p = 0.079). In model found by the stepwise forward selections, only the per capita income was um index related to less RMM (β = − 0.02; CI 95% -0.05 to − 0.002; r(2) = 0.15; p = 0.028). CONCLUSION: The findings showed that the per capita income has a negative association MMR in the different states of Brazil, but seems canceled because of the other socioeconomic determinants related to the poor live conditions.