Income inequality and youth pregnancies in Brazil: a regression analysis

Abstract

BackgroundTeenage pregnancies have often been linked to high mortality and poor economic outcomes in Brazil. Income inequality also affects several social and health problems but its association with youth pregnancy is unclear. We analysed this association and tested two hypotheses: first, that high income inequality affects reproductive decisions (ie, when few other options are available, women will decide to start childbearing earlier); and second, that teenagers living in regions of high inequality are likely to take risky behaviours to increase status. MethodsWe analysed every Brazilian municipality with 50 000–500 000 residents from 1998, to 2002, and calculated their birth rates from official data for three groups: children (age 10–14 years), adolescents (age 15–19 years), and adults (age 20–49 years). We tested associations with multiple regression models. FindingsWe analysed 494 municipalities. Income inequality was associated with child and adolescent birth rate for every model, but not adult birth rate. After controlling for poverty, an increase of Gini coefficient of 0·01 was associated with an increase in yearly births of 7·17 per 100 female adolescents (p=0·09), 0·854 per 100 children (p<0·0001), and and 1·57 per 100 adults (p=0·365). Both hypotheses were consistent with our results, but the relation between income inequality and adolescent fertility was still significant (p=0·003) after accounting for the variables associated with the two hypotheses (poverty, age-adjusted homicide rate, young adult mortality rate, and percentage of teenagers not in school). InterpretationWhen income inequality is high, young women view childbearing as an opportunity for a better life and enhanced social position within a community that does not offer many other options. The association between high income inequality and high youth fertility was consistently positive for Brazil, a country with very high income inequality, and could be an example for other countries in which inequality is growing. FundingCAPES.