Inequities in health: socio-demographic and spatial analysis of breast cancer in women from Cordoba, Argentina

Objective: To identify sociodemographic determinants associated with the spatial distribution of the breast cancer incidence in the province of Cordoba, Argentina, in order to reveal underlying social inequities. Method: An ecological study was developed in Cordoba (26 counties as geographical units of analysis). The spatial autocorrelation of the crude and standardised incidence rates of breast cancer, and the sociodemographic indicators of urbanization, fertility and population ageing were estimated using Moran's index. These variables were entered into a Geographic Information System for mapping. Poisson multilevel regression models were adjusted, establishing the breast cancer incidence rates as the response variable, and by selecting sociodemographic indicators as covariables and the percentage of households with unmet basic needs as adjustment variables. Results: In Cordoba, Argentina, a non-random pattern in the spatial distribution of breast cancer incidence rates and in certain sociodemographic indicators was found. The mean increase in annual urban population was inversely associated with breast cancer, whereas the proportion of households with unmet basic needs was directly associated with this cancer. Conclusions: Our results define social inequity scenarios that partially explain the geographical differentials in the breast cancer burden in Cordoba, Argentina. Women residing in socioeconomically disadvantaged households and in less urbanized areas merit special attention in future studies and in breast cancer public health activities. (C) 2017 SESPAS. Published by Elsevier Espafia, S.L.U.