Women's Empowerment in Latin American Cities and Its Influence on Mortality

Background: Women’s Empowerment (WE) has been shown to reduce infant mortality rates (IMR) in high-income countries. However, the role of WE in affecting IMR across growing cities of the global South has not been documented. Objectives: To examine whether WE is associated with differences in IMR across Latin American cities Methods: We estimated IMR for the period 2014-2016 using vital registration and demographic methods for 286 cities with population over 100,000 in 8 countries. We calculated socioeconomic (SE) and WE indicators from national census. We combined SE indicators into factors reflecting living conditions, and service provision. WE was measured using two indicators: women’s labor force participation (WLFP) and education attainment among women. We included a scale of country’s enforcements of laws (CEL) related to women’s rights. Using Poisson multilevel regression, we estimated the percentage difference in IMR associated with one standard deviation (1SD) higher WE scores, adjusted for SE characteristics of cities. Results: Overall IMR was 11.2 deaths per 1,000 live births. A 1SD higher score for WLFP was associated with 6.1% (95%CI -11.1; -0.8) lower IMR, after accounting for SE indicators. A higher CEL was associated with a lower IMR. Education attainment among women was inversely associated with IMR only in countries with low GDP per capita. Interpretation: Strategies that promote participation of women in labor market may have a positive impact in reducing IMR in Latin American cities. Women’s educational attainment is still relevant for reducing IMR in cities from countries with lower economic development. Funding Statement: Wellcome Trust Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Not required.