Understanding the social determinants of child mortality in Latin America over the last two decades: a machine learning approach


Por: Chivardi C., Zamudio Sosa A., Cavalcanti D.M., Ordoñez J.A., Diaz J.F., Zuluaga D., Almeida C., Serván-Mori E., Hessel P., Moncayo A.L., Rasella D.

Publicada: 1 ene 2023
Categoría: Multidisciplinary

Resumen:
The reduction of child mortality rates remains a significant global public health challenge, particularly in regions with high levels of inequality such as Latin America. We used machine learning (ML) algorithms to explore the relationship between social determinants and child under-5 mortality rates (U5MR) in Brazil, Ecuador, and Mexico over two decades. We created a municipal-level cohort from 2000 to 2019 and trained a random forest model (RF) to estimate the relative importance of social determinants in predicting U5MR. We conducted a sensitivity analysis training two more ML models and presenting the mean square error, root mean square error, and median absolute deviation. Our findings indicate that poverty, illiteracy, and the Gini index were the most important variables for predicting U5MR according to the RF. Furthermore, non-linear relationships were found mainly for Gini index and U5MR. Our study suggests that long-term public policies to reduce U5MR in Latin America should focus on reducing poverty, illiteracy, and socioeconomic inequalities. This research provides important insights into the relationships between social determinants and child mortality rates in Latin America. The use of ML algorithms, combined with large longitudinal data, allowed us to evaluate the effects of social determinants on health more carefully than traditional models. © 2023, The Author(s).

Filiaciones:
Chivardi C.:
 Centre for Health Economics (CHE), University of York, York, United Kingdom

Zamudio Sosa A.:
 School of Psychology, National Autonomous University of Mexico (UNAM), Mexico, Mexico

Cavalcanti D.M.:
 Institute of Collective Health (ISC), Federal University of Bahia (UFBA), Bahia, Salvador, Brazil

Ordoñez J.A.:
 Institute of Collective Health (ISC), Federal University of Bahia (UFBA), Bahia, Salvador, Brazil

Diaz J.F.:
 Alberto Lleras Camargo School of Government, Universidad de los Andes, Bogota, Colombia

 Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Basel, Switzerland

Zuluaga D.:
 Alberto Lleras Camargo School of Government, Universidad de los Andes, Bogota, Colombia

 Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Basel, Switzerland

Almeida C.:
 Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, Quito, Ecuador

Serván-Mori E.:
 National Institute of Public Health (INSP), Cuernavaca, Mexico

Hessel P.:
 Alberto Lleras Camargo School of Government, Universidad de los Andes, Bogota, Colombia

 Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Basel, Switzerland

Moncayo A.L.:
 Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, Quito, Ecuador

Rasella D.:
 Institute of Collective Health (ISC), Federal University of Bahia (UFBA), Bahia, Salvador, Brazil

 Institute of Global Health (ISGlobal), Barcelona, Spain
ISSN: 20452322
Editorial
NATURE PUBLISHING GROUP, MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 13 Número: 1
Páginas:
WOS Id: 001144297500070
ID de PubMed: 38012243
imagen Green Submitted, gold, All Open Access, Gold

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