Environmental and socio-economic determinants of infant mortality in Poland: an ecological study.

Agnieszka Genowska,Andrzej Szpak,Andrzej Pająk,Jacek Jamiołkowski,Krystyna Szafraniec,Urszula Stepaniak

doi:10.1186/s12940-015-0048-1

Agnieszka Genowska, Andrzej Szpak + Show 4 more

Open Access

https://doi.org/10.1186/s12940-015-0048-1

Copy DOI

Abstract

BackgroundHealth status of infants is related to the general state of health of women of child-bearing age; however, women's occupational environment and socio-economic conditions also seem to play an important role. The aim of the present ecological study was to assess the relationship between occupational environment, industrial pollution, socio-economic status and infant mortality in Poland.MethodsData on infant mortality and environmental and socio-economic characteristics for the 66 sub-regions of Poland for the years 2005–2011 were used in the analysis. Factor analysis was used to extract the most important factors explaining total variance among the 23 studied exposures. Generalized Estimating Equations model was used to evaluate the link between infant mortality and the studied extracted factors.ResultsMarked variation for infant mortality and the characteristics of industrialization was observed among the 66 sub-regions of Poland. Four extracted factors: “poor working environment”, “urbanization and employment in the service sector”, “industrial pollution”, “economic wealth” accounted for 77.3 % of cumulative variance between the studied exposures. In the multivariate regression analysis, an increase in factor “poor working environment” of 1 SD was related to an increase in infant mortality of 40 (95 % CI: 28–53) per 100,000 live births. Additionally, an increase in factor “industrial pollution” of 1 SD was associated with an increase in infant mortality of 16 (95 % CI: 2–30) per 100,000 live births. The factors “urbanization and employment in the service sector” and “economic wealth” were not significantly related to infant mortality.ConclusionThe study findings suggested that, at the population level, infant mortality was associated with an industrial environment. Strategies to improve working conditions and reduce industrial pollution might contribute to a reduction in infant mortality in Poland.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-015-0048-1) contains supplementary material, which is available to authorized users.

Highlights

Health status of infants is related to the general state of health of women of child-bearing age; women's occupational environment and socio-economic conditions seem to play an important role
In the majority of sub-regions, the infant mortality rate decreased during the study period (Fig. 1)
The study findings suggested that infant mortality was associated with industrial environmental conditions at the population level

Summary

Introduction

Health status of infants is related to the general state of health of women of child-bearing age; women's occupational environment and socio-economic conditions seem to play an important role. The aim of the present ecological study was to assess the relationship between occupational environment, industrial pollution, socio-economic status and infant mortality in Poland. There is evidence that environmental pollution and poor working conditions are related to low birth weight [14,15,16], preterm birth [17, 18], birth defects [19,20,21] and infant mortality [5, 22]

Methods

Results

Discussion

Conclusion