Differences In Infant Mortality Research Articles

Philippines 1998: results from the Demographic and Health Survey.

This article presents summary statistics gathered from the 1998 Philippine National Demographic and Health Survey. The National Statistics Office and the Department of Health within the framework of the Demographic Health Survey Program of Macro International conducted the survey. The nationally representative survey collected data from 12,407 households. Interviews were also conducted with 13,983 women aged 15-49 years between March 3 and the first week of May 1998. The statistical data presented were on fertility trends, fertility differentials, age-specific fertility, fertility preferences, current contraceptive use, contraception, marital and contraceptive status, postpartum variables, infant mortality trends and differentials, and children's health.

Health inequalities and the health of the poor: what do we know? What can we do?

The contents of this theme section of the Bulletin of the World Health Organization on "Inequalities in health" have two objectives: to present the initial findings from a new generation of research that has been undertaken in response to renewed concern for health inequalities; and to stimulate movement for action in order to correct the problems identified by this research. The research findings are presented in the five articles which follow. This Critical Reflection proposes two initial steps for the action needed to alleviate the problem; other suggestions are given by the participants in a Round Table discussion which is published after these articles. The theme section concludes with extracts from the classic writings of the nineteenth-century public health pioneer, William Farr, who is widely credited as one of the founders of the scientific study of health inequalities, together with a commentary. This Critical Reflection contributes to the discussion of the action needed by proposing two initial steps for action. That professionals who give very high priority to the distinct but related objectives of poverty alleviation, inequality reduction, and equity enhancement recognize that their shared concern for the distributional aspects of health policy is far more important than any differences that may divide them. That health policy goals, currently expressed as societal averages, be reformulated so that they point specifically to conditions among the poor and to poor-rich differences. For example, infant mortality rates among the poor or the differences in infant mortality between rich and poor sectors would be more useful indicators than the average infant mortality rates for the whole population.

The population transition and seasonal fluctuations in infant mortality in Finland, Estonia and Russia

ln explaining differences in infant mortality and its development in Finland. Russia and Estonia in regard to region, religious group and month of the year in the period 1750 - 1900, one can note the significance of breastfeeding. Wherever breastfeeding was common, infant mortality was low and there was no peak in infant mortality during the summer months. The basic reason for this was that breastfeeding was much more hygienic than other forms of feeding and, in addition. breast milk was a versatile source of nutrition. Economic reasons were of only secondary importance compared to thes eforms of feeding.

Regional Patterns of Infant Mortality Caused by Lethal Congenital Anomalies

Purpose: To assess the regional patterns of infant mortality due to lethal congenital anomalies, and the potential reasons for the regional patterns. Method: The study analyzed 2,507 infant deaths due to lethal congenital anomalies among 1,178,452 live births in 9 of the 12 Canadian provinces and territories from 1990 to 1995 recorded in Statistics Canada’s live birth and death data bases. Results: Compared with the province of Quebec, congenital anomaly-attributed infant mortality was higher in Newfoundland, Saskatchewan, and Alberta. These differences in infant mortality were substantial for cardiovascular system anomalies and especially anen-cephaly. For infant mortality due to chromosomal anomalies, however, there was little interprovincial variation. Conclusions: Despite substantial recent reductions in lethal congenital anomaly-attributed infant mortality, there remain major regional variations in infant mortality caused by certain forms of congenital anomalies including anen-cephaly and cardiovascular system anomalies.

Infant mortality in the Indian slums: case studies of Calcutta metropolis and Raipur city.

This study was conducted to examine the levels of infant mortality, its causes and determinants, and its differentials in selected slums of Calcutta Metropolis and Raipur in India. Data were gathered through interview of 2142 mothers who had experienced a live birth and/or death of an infant within the year prior to the survey. The study found that although the infant mortality rate (IMR) in the slums was quite high, it was lower compared to rural India. The study¿s finding underlines the importance of "urban residence" as a primary controlling factor of infant mortality. IMR was 1.5 times higher in the slums of Calcutta than in Raipur, indicating that infant death is far worse in the metropolis than in smaller cities. Although a number of individual-, household-, and slum-level factors played an explanatory role in infant mortality, differences in neighborhood environment contributed most significantly to the infant mortality differentials in the two slums. This study also found that mere literacy or low level of education is not an effective depressant of infant mortality.

Race/Ethnicity, Nativity, and Infant Mortality in the United States

The overall purpose of this article is to examine population differences in the risk of infant mortality by race/ethnicity, with special attention given to the influence of nativity. Data are taken from the National Center for Health Statistics (NCHS) linked birth! infant death files for 1989-91. Thesefiles cover virtually the entire nation, provide highly reliable data for relatively small racial/ethnic subpopulations, and have recently been updated to include new variables of interest. Results show that there is wide variation in the risk of infant death across racial/ethnic groups, with infants born to black women suffering the highest risks and infants oflapanese women experiencing the lowest risks. It is also clear that nativity has a crucial impact on racial/ethnic differentials in infant mortality. In fact, the favorable infant survival rates of many racial/ethnic gro ups are largely attributable to a high percentage of births to immigrant women, who are characterized by overall lower infant mortality than native-born women. Both the racial! ethnic differentials in mortality and the effect of nativity, in turn, are due to several sets offactors, the importance of which varies by race/ethnicity. Models of infant mortality estimated separately by race/ethnicity also revealed that the direction of effects for mortality riskfactors tends to be the same across groups, although the magnitudes vary. Thus, it is reasonable to assume thatgeneral efforts to lower infant mortality will have a beneficial impactfor all groups.

Marital Status and Infant Mortality

This paper examines the relationship between marital status and infant mortality in Jamaica. Discrete-time hazard models that account for unobserved heterogeneity are estimated using the demographic histories of the 1975/76 Jamaican Fertility Survey. The analysis indicates that marital status is an important factor in explaining differences in infant mortality. More specifically (and contrary to what is found unconditionally) infant mortality is higher in common-law (and visiting) unions compared to marriage after other factors thought to affect infant mortality are held constant. (EXCERPT) (SUMMARY IN FRE)

Infant mortality in Denmark and Sweden: A comparison based on data in two national registries

Objectives: To study in detail the differences in infant mortality between Denmark and Sweden. Study design: Data retrieved from national health registers on infant death rates were compared for 1980–1988, supplemented with a study on the impact of socio-economic conditions in 1985–86 (Denmark) or 1986 (Sweden). Results: Even after stratification for maternal age, parity, and socio-economic group, the Danish mortality rate was higher in all age-at-death intervals except for stillbirths. Maternal age-parity distribution was more favourable in Denmark, the socio-economic distribution in Sweden. The most marked country differences was seen in young women. The difference in the rate of perinatal deaths but not of later deaths is explainable by a more favourable birth weight distribution in Sweden than in Denmark. Conclusions: The studied variables do not explain the difference in mortality risk but it may be due to life style factors so far not identified.

Guatemala 1995: Results from the Demographic and Health Survey

The Guatemala National Survey of Maternal and Child Health was national in scope, but lacked data from 1 region (2% of the population). 5459 households took part; complete interviews with 5160 women aged 15-44 took place. The survey was done between September 25-December 16, 1987. Summary statistics are presented in tables. They give general population characteristics (both demographic and economic); distribution of survey sample population by socioeconomic characteristics (percent women); fertility statistics--trends, differentials, and age-specific fertility; fertility preferences (ideal number of children, desire to stop childbearing; planning status of births by birth order); current contraceptive use--contraceptive prevalence differentials; contraceptive prevalence by age and parity; source of contraceptive supply for current users of supply or clinic methods; contraception facts--"knowledge and use of contraceptive methods among women married or in union;" reaction to getting pregnant among women who do not use contraceptives, and women who gave up a method in the last 5 years. Nuptiality and contraceptive status are given in charts headed by "current marital status." Postpartum variables given include: "duration of postpartum interval by current status;" "differentials in breast feeding and amenorrhea;" and "postpartum status by duration since birth." Infant mortality trends, differentials, 1977-87; and children ever-born and surviving are also given. "Health: disease, treatment, and prevention, as given by "percent of children 12-23 months of age with health and, of those, percent immunized;" "percent of children under 5 years" with diarrhea 2 weeks before the survey, and of those, percent receiving different treatments;" and "type of assistance during delivery for births" in the 5 years before the survey. Nutritional status: anthropometric measures lists the percent of undernourished among children who are aged 3-36 months according to child's weight-for-height; and percent of undernourished children aged 3 to 36 months according to children's height-for-age.

Ethnic differences in rates of infant mortality and sudden infant death in Sweden, 1978-1990

This study examined ethnic differences in infant mortality rates (IMRs) and rates of sudden infant death syndrome (SIDS) among Swedish and immigrant women between 1978 and 1990 in Sweden. The study population comprised 1,265,942 single live births to women between the ages of 15 and 44 years in Sweden. Data from 3 registers In Sweden were linked to obtain medical and sociodemographic information for each mother and child in the study. Logistic regression analyses were employed to assess ethnic differences in infant mortality and SIDS while controlling for relevant confounders. This study revealed no ethnic differences in IMRs. There were also no ethnic differences in the mortality rates due to SIDS, except for immigrant women from Southeast Asia and the Pacific Islands who experienced significantly higher rates of SIDS than Swedish women. This study shows that, in general, the IMRs and mortality rates due to SIDS are not a serious public health problem among immigrant women in Sweden and suggests several reasons why this is the case.

Infant mortality and soil type: a case study in south‐central England (with discussion)

SummaryWe have analysed the differences in infant mortality for 1981 to 1990 in areas of contrasting soil types in south‐central England. The soils overlie rocks of varied lithology and hydrology, ranging from porous and permeable Chalk and limestones, to the generally wet and impermeable Oxford and Lower Jurassic Clays. The study area comprises 504 administrative wards, for each of which the soil has been classified as being predominantly‘Wet’, ‘ Intermediate’ or ‘Dry’, depending on the degree of seasonal or periodic waterlogging. The soil classes used are those mapped by the Soil Survey of England and Wales and relate closely to the underlying geology. We find proportionately more infant deaths on the‘Wet’ soils, and a gradation towards lower infant mortality rates on the drier soils. Overall, infant mortality on the‘Wet’ soils is 31·9 percent greater than on the‘Dry’ soils, for reasons that remain unexplained. This relation between infant mortality and soil moisture remains after the effect of social class has been removed.

Socioeconomic inequalities in perinatal and infant mortality from 1854 to 1990 in Amsterdam, The Netherlands

Trends in socioeconomic differences in infant and perinatal mortality in Amsterdam were studied for the period 1854–1990, using published and unpublished material, at the aggregate and at the individual level. Absolute and relative socioeconomic mortality differences (SEMD) per data-set were calculated using inequality indices developed by Pamuk. The results show a decrease of the absolute differences in both infant and perinatal mortality. For infant mortality, this is mainly due to the overall decline of the infant mortality rate. Relative differences in infant mortality did not decrease during the study period. This is the result of separate developments in 3 time periods. From approximately 1850 to approximately 1910 an increase in relative differences can be seen, a trend which is reversed from approximately 1910 to the end of World War II. After World War II relative differences seem to stabilize at the same level. For perinatal mortality, for which only data from the post-World War II period are available, the decrease in the absolute differences is due both to the overall decline of the perinatal mortality rate and to a decline of relative differences between socioeconomic groups. It is conduded that although SEMD in infant and perinatal mortality have declined in an absolute sense, they still exist and that the relative position of deprived groups concerning infant mortality was not ameliorated during the study period.

Race, income, and infant mortality in Cape Town, South Africa.

Birth notification information for 1982 infant mortality data for 1981-1983 and death certificate data on 42360 people dying in the area of greater Cape Town over the period 1981-84 were examined in an assessment of the influence of race and income upon the infant mortality rate (IMR) in Cape Town South Africa. The 1980 census tracts were aggregated into 258 local areas with approximately 5000 inhabitants each while the median head of household income per local area by race was used as proxy for socioeconomic status. The IMR was 8.4/1000 among Whites 26.8/1000 among Coloreds and 39.2/1000 among Black Africans. Among Whites IMR ranged from 7.3/1000 in the high income category to 13.1/1000 among those of low income. The same socioeconomic differences in IMR were observed among Coloreds . The proportion of neonatal deaths was 74% among Whites 66% among Coloreds and 44% among Africans. No relationship was identified between post-neonatal mortality and income categories in Whites while the highest post-neonatal mortality rate was identified among Africans. The low IMR among Whites of all socioeconomic levels reflects the low quantitative and qualitative health services available to Black Africans and Coloreds in Cape Town compared to those provided to Whites. The inferior health statuses of Black Africans and Coloreds directly results. Socioeconomic status also plays an important determining role in health and survival statuses both between and within racial categories.

The impact of women's status on infant mortality rate: A cross-national analysis

A number of prior studies have attempted to account for cross-national differences in infant mortality rate using a variety of economic, demographic, and health related variables. These studies have given relatively little attention to the impact of predictors measuring the status of women. The present study, based on a sample of 96 less developed countries circa 1990, tests a series of hypotheses derived from gender stratification theory and industrialism theory. Evidence is presented of an inverse relationship between the status of women and infant mortality rate. The present study shows that it makes a difference whether we use relative or absolute measures of women's status and it shows that in addition to women's educational status, other dimensions of women's status particularly economic status and autonomy are also important predictors of infant mortality rate.

Areal and socioeconomic differentials in infant and child mortality in Cameroon

Given its geographical, socio-economic, ethnic and cultural diversity, Cameroon offers an excellent setting for investigating the contribution of geographical and socioeconomic factors to mortality differences in infancy and childhood. Such research is crucial for designing appropriate health policies at the national and regional levels. Using data from a nationally representative sample of more than 12,000 births, this study assesses infant and child mortality differences in Cameroon by residence area, mother's education, ethnicity, marital status and union type, religion and the interplay of those factors on differentials mortality. The most vulnerable groups of children in the country are: rural residents; residents of the East, North and South-West regions; Kaka-Baya and Fulbe-Fulani children; and children whose mothers have no education, are Traditionalists, are unmarried, or are in polygamous unions. Lack of maternal schooling alone explains all the excess childhood mortality of Fulbe-Fulani children, most of the excess mortality of children of the North and East regions, most of the excess mortality of the countryside vis-à-vis the metropolitan areas of Yaoundé and Douala, and most of the excess mortality of children of Traditionalists. The robustness of the excess neonatal mortality of newborns in the East region probably reflects the higher prevalence of tetanus in that region compared to the rest of the country. The study also suggests that the place/region of residence in Cameroon is likely to be a proxy for inequalities in the provision of and/or use of health services.

Urban-rural differentials in infant mortality in Victorian England.

This paper examines the magnitude of urban-rural differentials in infant mortality in England during the nineteenth and early twentieth centuries and also compares the timing of decline for a selection of towns of varying size, and their immediate rural hinterlands. Most towns continued to experience short-term fluctuations in infant mortality until the very end of the nineteenth century; however, in some of the adjacent rural communities--where levels of infant mortality were much lower--conditions were sufficiently favourable to allow a continuous decline in infant mortality from at least the 1860s, if not before. The final part of the paper considers the causes of these patterns and their implications for explanations of infant mortality decline.

Infant mortality in the United States: trends, differentials, and projections, 1950 through 2010.

This study examined long-term trends and differences in infant mortality in the United States from 1950 through 1991 according to race and ethnicity, education, family income, and cause of death. Forecasts are made through the year 2010. Log-linear regression models were applied to data from the National Vital Statistics System, National Linked Birth and Infant Death files, the National Maternal and Infant Health Survey, the National Natality Survey, and the National Infant Mortality Survey to model and forecast infant mortality. Dramatic declines in the US infant mortality rate have occurred in the past 4 decades, largely as a result of declines in mortality from pneumonia and influenza, respiratory distress syndrome, prematurity and low birthweight, congenital anomalies, and accidents. Despite the overall reductions, however, substantial racial/ethnic, educational, and income differences in infant mortality still exist. The long-term downward trend in US infant mortality has not benefited Blacks and Whites equally. The Black/White disparity in infant mortality has not only persisted but increased over time and is not expected to diminish in the near future. Educational inequalities have also widened, and racial disparities have generally increased across all educational levels.

Trends and differentials in infant mortality in the Soviet Union, 1970-90: How much is due to misreporting?

We use recently released data on perinatal mortality and cause of death to assess how much of the spatial and temporal variation in infant mortality in the former Soviet Union is attributable to differences in the extent of misreporting. We demonstrate that the dramatic rise in infant mortality that occurred in the mid-1970s was accounted for in large part by an increase in death rates from causes which predominate after the first month of life, particularly in the Central Asian republics, but also in the more developed Baltic and European republics. Improvements in the classification of perinatal deaths do not appear to have played a significant role in explaining trends in reported infant mortality in the 1970s, but may have been responsible for some of the rise (or lack of decline) during the late 1980s. Despite the apparent improvements in the recording of deaths that occurred shortly after birth, there is evidence in several republics of substantial misclassification of early infant deaths as late fe...

Socio-economic differentials in infant and child mortality during mortality decline: England and Wales, 1890-1911.

In this paper data from the 1911 Census of the Fertility of Marriage of England and Wales are used to study patterns of mortality decline by socio-economic characteristics, principally the occupation of husband. That census reported data on number of wives, children ever born, and children dead by marriage-duration cohorts for 190 non-overlapping occupations of husband. These results, along with those on number of rooms in the dwelling of the family are used to make indirect estimates of childhood mortality using the techniques described in United Nations, Manual X. These procedures produce values of q(a), the probability of dying before reaching some exact age ‘a’. Estimates for q(2), q(3), q(5), q(10), q(15), and q(20) are derived from data on women married 0–4, 5–9, 10–14, 15–19, 20–24, and 25–29 years, respectively. These estimates can also be dated to a point in the past. These values can also be converted to a corresponding level of a Model West life table, which describes the ‘average’ mortality re...

The determinants of infant and child mortality in Tanzania.

This paper investigates the determinants of infant and child mortality in Tanzania using the 1991/92 Tanzania Demographic and Health Survey. A hazards model is used to assess the relative effect of the variables hypothesized to influence under-five mortality. Short birth intervals, teenage pregnancies and previous child deaths are associated with increased risk of death. The Government of the United Republic of Tanzania should therefore maintain its commitment to encouraging women to space their births at least two years apart and delay childbearing beyond the teenage years. Further, this study shows that there is a remarkable lack of infant and child mortality differentials by socioeconomic subgroups of the population, which may reflect post-independence health policy and development strategies. Whilst lack of socioeconomic differentials can be considered an achievement of government policies, mortality remains high so there is still a long way to go before Tanzania achieves its stated goal of 'Health for All'.