Abstract
To analyze the intra-urban differentials related to the outcome of the Newborn Hearing Screening (NHS) of children living in Belo Horizonte tested in a reference service using the Health Vulnerability Index (HVI). cross-sectional study with children living in Belo Horizonte evaluated by a Newborn Hearing Screening Reference Service (NHSRS) between 2010 and 2011. The HVI of the census tract of each child was obtained by the georeferencing of their respective addresses. Multivariate analysis was conducted using the decision tree technique, considering a statistical model for each response. A thematic map of points representing the geographic distribution of the children evaluated by the NHS program was also developed. The NHS failure rate for children living in areas with very high HVI, or without HVI data, was 1.5 times higher than that for children living in other census tracts. For children living in areas of low, medium, and high HVI, who underwent NHS after 30 days of life, the NHS failure rate was 2.1 times higher in children that presented Risk Indicator for Hearing Loss (RIHL) (17.2%) than in those who did not (8.1%). Uneven distribution was observed between areas for children that underwent the NHS and those who failed it. Significant intra-urban differentials were found in Belo Horizonte, indicating correlation between health vulnerability and NHS outcomes.
Highlights
Newborn Hearing Screening (NHS) is a hearing loss identification strategy that enables early intervention in neonates and, the development of oral language in children with hearing impairment[1,2]
With respect to the district of origin, the newborn hearing screening reference service (NHSRS) evaluated children living in all health districts of the municipality, the proportion of children in the sample has varied from 16.9% (District Norte) to 4.6% (District Centro-Sul)
The analysis of this study reveals that the results of Newborn Hearing Screening (NHS) was inversely associated with the Health Vulnerability Index (HVI), with a higher failure rate proportion for children living in deprived health areas; the same was not observed in relation to absenteeism in the retesting phase and retest results
Summary
Newborn Hearing Screening (NHS) is a hearing loss identification strategy that enables early intervention in neonates and, the development of oral language in children with hearing impairment[1,2]. Newborn Hearing Screening Programs (NHSP) should assess the entire population of live births within their coverage areas in order to enable positive impact on the health condition of children with hearing impairment[7,8]. The effect of social inequalities on the health condition has been studied for several decades. Such studies aim to understand the relationship between epidemiological and socioeconomic indicators. Individuals and areas with unfavorable socioeconomic conditions almost invariably present poor health[9]
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