Ariela Braverman-Bronstein, Ana F. Ortigoza, Dèsirée Vidaña-Pérez, Tonatiuh Barrientos-Gutiérrez, Laura Baldovino-Chiquillo, Usama Bilal, Amélia Augusta de Lima Friche, Francisco Diez-Canseco, Julie Maslowsky, Alejandra Vives V., Ana V. Diez Roux. Gender inequality, women’s empowerment, and adolescent birth rates in
363 Latin American cities. Social Science & Medicine (2022). Volume 317.
Background Gender inequality is high in Latin America (LA). Empowering girls and young women and reducing gender gaps has been proposed as a pathway to reduce adolescent pregnancy. We investigated the associations of urban measures of women’s empowerment and gender inequality with adolescent birth rates (ABR) in 366 Latin American cities in nine countries.
Methods We created a gender inequality index (GII) and three Women Achievement scores reflecting domains of women’s empowerment (employment, education, and health care access) using censuses, surveys, and political participation data at city and sub-city levels. We used 3-level negative binomial models (sub-city-city-countries) to assess the association between the GII and scores, with ABR while accounting for other city and sub-city characteristics.
Results We found within country heterogeneity in gender inequality and women’s empowerment measures. The ABR was 4% higher for each 1 standard deviation (1-SD) higher GII (RR 1.04; 95%CI 1.01,1.06), 8% lower for each SD higher autonomy score (RR 0.92; 95%CI 0.86, 0.99), and 12% lower for each SD health care access score (RR 0.88; 95%CI 0.82,0.95) after adjustment for city level population size, population growth, homicide rates, and sub-city population educational attainment and living conditions scores.
Conclusion Our findings show the key role cities have in reducing ABR through the implementation of strategies that foster women’s socioeconomic progress such as education, employment, and health care access.