Temporal variations in the relationship between infant mortality and economic status

Data from a metropolitan aggregate comprising three Ohio cities for the years 1959–61, 1969–71 and 1979–81 reveal some noteworthy variations over time in the nature and magnitude of the traditional inverse association between economic status and infant mortality. This brief paper describes these variations and offers an explanation for the observed temporal changes that relates the influence of medical and infant health care advances to the prevailing overall economic situation.

     

Some aspects of the relationship between the levels of infant mortality and fertility in the ESCAP region

The death of a child within the first year of life is a crucial factor in fertility decisions in a developing country. The infant mortality rate gives a close, inverse indication of the socioeconomic conditions of a country. This paper presents studies by Brass, Rutherford, Chowdhury, Khan and Chen, Agrawal, Iskander and Jones, in summary/abstract form. It concludes that the probabilities of survival are poorer for births of older women and/or higher parities. Early child deaths may increase the total period of exposure to the risk of conception. A lower infant and child mortality norm calls for fewer births to meet the needs for survivors. Child replacement motivational response seems to be strongest with the birth immediately following a death event. Agrawal analyzed the interval between successive births of 1107 women of Patna, Pakistan, according to the age of mother and sex and fate of the previous child. He observed that if a child died shortly after its birth, often a new pregnancy began within a short interval. The interval between 2 consecutive live births when the previous child was male and alive was greater than when the previous child was female and alive. The interval between 2 births was reduced if the child died in infancy and specially if this was a male child.     

Early origins of the gradient: the relationship between socioeconomic status and infant mortality in the United States

Although relationships between social conditions and health have been documented for centuries, the past few decades have witnessed the emergence of socioeconomic gradients in health and mortality in most developed countries. These gradients indicate that health improves, although decreasingly so, at higher levels of socioeconomic status. To minimize problems with reverse causality, I tested competing hypotheses for observed socioeconomic gradients for infant mortality outcomes. I found no support for the income-inequality hypothesis and negligible support for the occupational-grade hypothesis. The results indicate that absolute material conditions are the most important determinants of socioeconomic effects on the risk of infant mortality and that while poverty has the most pronounced effect on risk, income is decreasingly salutary across the majority of the mortality gradient.     

Trends in the relationship between socioeconomic status and infant mortality in metropolitan Ohio, 1960–1990

This paper presents the results of an ecological analysis of the relationship between infant mortality and economic status in metropolitan Ohio at four points in time centering on the censuses of 1960, 1970, 1980 and 1990. The basic unit of analysis is the census tract of mother's usual residence, with economic status being determined by the percentage of low income families living in each tract. For each period, the census tracts were aggregated into broad income groups and three-year average infant mortality rates were computed for each area, by age, sex, race and exogenous-endogenous causes of death. The most important conclusion to be drawn from the data is that in spite of some very remarkable declines in infant mortality for all socioeconomic groups since 1960, there continues to be a very clear and pronounced inverse association between income status and infant mortality. Indeed, there is some evidence to suggest that it is stronger in 1990 than it was three decades earlier. The general inverse association is observed for both sexes, for whites and nonwhites, and for all major causes of death. At the same time, the data reveal notable variations in the pattern of the relationship over time, as well as several differences between whites and nonwhites in the nature and magnitude of the relationship. Some macro-economic hypotheses are offered to explain these temporal and racial differences in the pattern of the relationship between economic status and infant mortality.This article is an expanded version of a paper presented at the annual meetings of the Southern Demographic Association in New Orleans, 21–23 October 1993.     

Using satellite imagery to measure the relationship between air quality and infant mortality: an empirical study for Mexico

This research uses a unique dataset that provides relatively inexpensive measures of air quality at detailed geography. The analytical focus is the relationship, in Mexico, between Aerosol Optical Depth (AOD, a measure of air quality obtained from satellite imagery) and infant mortality due to respiratory diseases from January, 2001 through December, 2006. The results contribute to existing literature on the relationship between air pollution and health outcomes by examining, for the first time, the relationship between these variables for the entire land area of Mexico, for most of which no ground measures of pollution concentrations exist. Substantive results suggest that changes in AOD have a significant impact on infant mortality due to respiratory diseases in municipalities in the three highest AOD quartiles in the country, providing evidence that air pollution’s adverse effects, although nonlinear, are not only present in large cities, but also in lower pollution settings which lack ground measures of pollution. Methodologically, it is argued that satellite-based imagery can be a valuable source of information for both researchers and policy makers when examining the consequences of pollution and/or the effectiveness of pollution-control mechanisms.     

Estimates of mortality from infant mortality rates

Estimates of mortality rates and expectation of life at birth, using infant mortality rates, are examined on the basis of 150 life tables for both sexes. Least squares linear estimates are given as well as estimates of their variances. Model life table calculations, as proposed by the U.N. Population Branch, are then compared with these unbiased minimum variance estimates and shown to overestimate the expectation of life by more than two years on the average, and to be at most 68% efficient. Though better estimates are provided in this paper, their variance is still so large as to cast doubt on the practical usefulness of anv estimates based exclusively on infant mortality rates.     

On the relationship between population and education]

The social and historical development of population and education is subject to the restriction of the means of production. Although it is not the major factor in determing the direction of social development, it has a great impact on social progress and historical development. The scale and level of educational development are not only influenced by social and economic conditions but are also related to the scale of population growth and the number of people who receive an education. In studies of the relationship between the population and education, special attention should be given to the impact of population growth upon education as well as the everlasting influence of education upon the population structure and social mobility. Since 1949, because of a rapid population growth, the existing educational system in China has suffered severe damage and destruction. There have been an insufficient number of schools and a shortage of funds for education for quite some time, and the population growth has caused great pressure on education. The relationship between the population and education in a modern society is a rather complicated problem. As a country with a large population and a backward education, China needs to develop its education and promote its population quality in order that favorable conditions may be created for the overall development of Socialist modernization.     

Estimating infant and childhood mortality under conditions of changing mortality

Summary It is well known that estimates of infant mortality obtained using Brass's technique are very accurate. Biases are introduced, however, when one or more of the assumptions on which it relies are violated. Departures from the assumption of constant fertility may be handled by using a variant of the technique which depends on information on the age distribution of surviving children, rather than on indexes of the fertility function. Violations of the assumption of constant mortality - an increasingly common situation in most developing societies - produce upward biases in the estimates. The amount of bias is a function of the speed of mortality decline, the characteristics of the fertility pattern and, finally, of the age of the mother. This paper presents a simple technique which corrects these biases, and in addition, generates estimates of the parameters of the mortality trend. It differs from others in that it uses a cohort definition of mortality decline and relies on knowledge of the age structure of surviving children rather than on indexes of the fertility pattern.     

Relationship of infant mortality and community development

A researcher applied indirect estimation techniques to data from 352 rural villages from the 1978 Republic of the Philippines Fertility Survey to determine if community factors affect mortality of children 5 years old. Children with the highest mortality risks included those of the poor and least educated parents. For example, infant and child mortality stood at 203 among mothers with no education compared to 42 among those with at least a college education. In addition, infant and child mortality among husbands who were farmers was 111 whereas it was 28 among husbands who worked in professional and clerical jobs. Low cost health services and midwives were the health factors that had the greatest effect ion the probability of survival for children 5 years old, especially among the poor and least educated. For example, the probability of dying fell from 123-80 among the poor and 152-79 among the least educated if a dispensary was accessible and from 131-88 among the poor and 154-96 among the least educated if a midwife was accessible. Furthermore, adequate nutrition, better housing conditions, safe water, and sanitation also played a key role in reducing the probability of death. In terms of community development, only accessibility to a newspaper outlet the families were. On the other hand, the presence of electricity was significant only when education of the mother, occupation of the father, and region of residence were used as control variables. Thus the government should expand health care services to the rural population. Further, it should integrate health components in social and economic development programs     

Beyond infant mortality: gender and stillbirth in reproductive mortality before the twentieth century

Though it has been the largest component of reproductive mortality since its statutory registration in 1928, stillbirth has received little attention from historical demographers, who have relied on the more orthodox indicator of early human survival changes - "infant mortality". The exclusion of stillbirth hampers demographic analysis, underestimates progress in newborn vitality, and over-privileges post-natal causes in theoretical explanation. A case is made for estimating stillbirth before 1928 as a ratio of early neonatal death, and for employing perinatal mortality as an historical indicator of female health status. The long-run trend of reproductive mortality (encompassing mature foetal and live born infant death during the first eleven months) reveals a substantial decline in perinatal causes in the first industrial century (1750-1850), implying a major concurrent improvement in the nutritional status of child bearers. Reproductive mortality is a more complete indicator of death in infancy. It offers demographers a means of fracturing the fertility versus mortality dualism and a potential purchase on gender as a demographic variable, while re-opening the case on mortality in the demographic dynamic of the world we have lost.     

On the relationship between population growth and economic development]

People are producers as well as consumers. If we look at only one side and ignore the other, we will be unable to reach impartial conclusions concerning the population problem. An obvious and close relationship exists between population growth and national economic development. If the two do not match each other, there will be numerous contradictory problems. For example, if the population grows too fast, serious social and economic problems will be created, such as a rise in the demand for living resources, an oversupply of the labor force, unemployment, and an insufficient availability of arable land, a shortage of public housing, more demand for health care and public transportation, and cultural and educational enterprises. In addition, a rapid population growth may cause more problems for the natural environment. As a result of overpopulation, the pressure on natural resources will be intensified and may therefore cause damage to the environment and create an ecological imbalance. All the above may bring very serious difficulties and obstacles to the advancement of socialism and modernized constructions. To avoid this, we must try to solve the population problem thoroughly and maintain a balanced relationship between the population growth and economic development.     

On the relationship between household composition and population age distribution

Summary Composition of households by age of head and by age of other household members has recently been presented in a convenient algebraic expression, the household composition matrix. It has been shown that this matrix operates as a linear transformation from the vector of household distribution by age of head to the vector of population age distribution. A further analysis will show that the first row of the matrix may be interpreted as representing a vector of average household fertility rates. If the linear relationship between household and population distributions is fully implemented, then a relationship between household fertility and the size of the youngest age group can be derived. If w is the population age distribution and w (1) is the number of persons in the youngest age group, then: where α is the first row of the household composition matrix with its first element eliminated, C is the household composition matrix with its first row and first column eliminated, and Ψ is the vector w with its first element, w (1) eliminated. Extension of this result will enable simultaneous projection of population and households, suitable for computer application to conventional five-year age groups.     

On the relationship between population and means of subsistence]

Population is the basis of all social activites and social production. Population growth and development must have a definite means of subsistence to meet its cultural and material needs. The larger the population of a country, the greater is its demand for consumer goods and, likewise, the yield of its means of subsistence should be greater. Population brings about the unification of production and consumption. Furthermore, the ratio of population to the means of subsistence must be maintained at an appropriate level. Population growth must be slower then the growth of the means of subsistence in order to ensure continuous economic expansion and population increase. However, there are some people, notably Malthus, who believe that the balance between population growth and the means of subsistence should be equal. It is crucial to note differences between Marxist and Malthusian points of view. The basic outlook on the nature of the relationship between population and the means of subsistence is different. For Malthusians, it is a matter of the number of people and the quantity of the means of subsistence. For Marxists, the relationship is a historically determined social relationship. For Malthusians, population development is the primary force behind social development, i.e., the imbalance between population and the means of subsistence stems from social ills. Marxists differ from this in believing that population cannot be divorced from material production. Malthusians believe that population surplus derives from a population increase that is greater than an increase in the means of subsistence. Marxists believe a population surplus is also an historically determined social relationship. The Malthusian outlook for the future of population and the means of subsistence is pessimistic, whereas the Marxian view embodies the optimism of revolution.     

Registration completeness and international comparisons of infant mortality

The physical development of the live born infant is the single most important variable governing its survival: infant mortality among those weighing 2,500 grams (5 1/2 pounds) or less at birth is 17 times the mortality among those weighing more than 2,500 grams at birth. The variation in mortality according to birth weight (or gestation) is greater than for subclasses of color, sex, maternal age, or birth order. Infant mortality in the United States is significantly higher than in a number of other countries e.g., Sweden, Netherlands, Norway. The difference is thought, by some, to be due to underregistration of low birth weight infants in other countries. In this paper, distributions of live births by birth weight for Denmark, England and Wales, New Zealand, and the United States, and infant mortality data for Denmark and the United States are examined. The data do not support a hypothesis of gross underregistration of live born infants in other countries. The results indicate that some index of physical development (birth weight, gestation, or a combination of both) should be included in any appraisal of infant mortality.     

A problem in measuring infant mortality]

Infant mortality rates refer to the number of infant deaths in a given calendar year divided by the total number of births for the same year. It is argued that this definition presents a logical problem, such that if "infant" is defined as any child less than 1 year old, then the set of criteria for infants born in January of the given calendar year is totally different for that of infants born in December. Due to the tremendous significance of infant mortality rates in assessing the socioeconomic growth of a given area, discrepancies such as the problem presented cannot be easily overlooked, particularly where small populations are concerned. A more accurate yet problematic approach for small populations, i.e., calculating the rate of infant mortality based on infant birthdays, using proposed linear regression scheme is presented.     

Levels and patterns of infant and child mortality in ghana

This paper attempts to measure infant and child mortality levels and also to determine their structure by utilizing the results of the 1968–1969 National Demographic Sample Survey which was conducted under the directorship of the author. Among the major problems encountered in the exercise are the adjustment of the current raw mortality data and the estimation of infant and child mortality from independent source material. The estimated infant mortality rates range from 56 per 1,000 live births in the Accra Capital District to 192 in the Upper Region during the late 1960’s. The urban rate is lower than the rural rate, 98 as against 161 per 1,000 live births. A large proportion of the deaths among children aged 0–4 occur in the second year of life, and deaths in this age group account for the bulk of the deaths within the age group 1–4 years.     

Transitions in mortality and health: theory,comparison and historical evidence

"The central aim of the present article is to review the theoretical and historical bases of the comparative perspective, in which the theory of epidemiological transition is normally used in order to improve our understanding of peripheral transitions in the evolution of the European mortality rate between 1860 and 1960.... We propose not so much a new theory speculating on the causes of the advances, which are irreversible after a certain point in the survival of western populations during the nineteenth and twentieth centuries, as a new way of looking at existing interpretations. Specifically, we have attempted to justify the need for a perspective which gets away from the usual approach, based on a sequential arrangement of the stages within a scale of evolution, and on a causal impulse behind those stages, deriving from a global socio-economic process."     

Urban determinants of racial differentiation in infant mortality

This study relates differential socioeconomic status between blacks and whites to racial differentiation in infant mortality rates. The basic assumption is that decreases in socioeconomic differentiation and related variables lead to decreases in the black—white infant mortality differential. A comparative approach based on aggregate measures of socioeconomic differentiation is utilized to compare sixty-one United States urban places. Path analysis shows that neonatal mortality differentiation is virtually unaffected by socioeconomic differentials while decreased racial differences in hospital births tend to increase neonatal mortality differentiation. In contrast, postneonatal differentiation is affected by socioeconomic differentiation, especially along the dimensions of income, education, and regional location. It is concluded that despite some suggestions that infant mortality is no longer responsive to socioeconomic factors, postneonatal differentation is affected by socioeconomic differentials when comparison is based on city units.