Causes of mortality and social determinants in early childhood in Zacatecas, Mexico, 2020–2025

Early childhood mortality is a priority public health issue, as it reflects not only clinical conditions but also social, family-related, and health service access inequalities. The objective of this study was to analyze the main causes of mortality and the social determinants associated with deaths among children older than 28 days and up to five years of age in Zacatecas, Mexico, during the 2020–2025 period. A mixed-method study with a quantitative, cross-sectional, and analytical design was conducted, based on official records, clinical files, verbal autopsies, and reports issued by Child Mortality Committees. A total of 240 deaths were analyzed. Infectious causes were the most frequent diagnostic group, accounting for 44.2% of cases, followed by asphyxia, with 25.4%; congenital/perinatal causes, with 13.3%; and other causes, with 17.1%. Among the social determinants identified, low caregiver education was present in 41.7% of cases, non-institutional initial care in 40.4%, and barriers to health service access in 38.8%.The findings show that early childhood deaths occurred within contexts characterized by the accumulation of social, family-related, and health care access vulnerabilities. It is concluded that mortality in this age group should not be interpreted solely as the result of immediate clinical causes, but rather as a preventable and socially conditioned phenomenon that requires comprehensive prevention strategies, community surveillance, strengthening of primary health care, and caregiver training.