The relationship between socioeconomic status and infant mortality in a metropolitan aggregate, 1989–1991

Abstract

This paper presents the results of an ecological analysis of the relationship between infant mortality and economic status in a metropolitan aggregate comprised of seven of the larger cities in Ohio during the three years centering on the 1990 census. Using a summary income score derived for the census tract of mother's usual residence, the census tracts in the seven metropolitan centers were divided into broad income groupings and three-year average infant mortality rates were computed for each area, by age, sex, race, and selected causes of death. The most important conclusion to be drawn from the data is that in spite of some remarkable declines in overall levels of infant mortality during the past few decades, there continues to be a very clear and pronounced inverse association between income status and infant mortality. The general inverse association is observed for both sexes, for whites and nonwhites, and for all major causes of infant death. At the same time, the data reveal notable differences in the magnitude of the relationship by sex, and especially by age at death, race, and cause of death. Explanations of these differences are suggested, and a conclusion notes some of the difficulties encountered in developing programs aimed at closing the infant mortality gap between the richest and poorest segments of the society.