Mortality in Ghana: Evidence from the cape coast project data

Abstract This paper deals with the estimation of mortality for a rural community of about 20,000 persons in the rain-forest area of south-west Ghana. Specifically, infant, child and adult mortality estimates have been obtained by the application of a wide range of direct and indirect methods of measuring mortality from the different statistics collected by a longitudinal mortality and fertility project conducted during 1974-7. It was noted that infant and childhood mortality rates obtained from death registrations were consistent with those rates yielded by pregnancy histories and child survival statistics. However, the adult mortality estimates derived from orphanhood statistics tended to be lower than those suggested by death registrations. The analysis revealed an infant mortality rate of 100 for boys and 84 for girls, equal childhood mortality rates for boys and girls (85-6), a lower expectation of life at birth for men (45.8 years) than for women (52.8), and a much more severe incidence of mortality among men aged over 40 than for women at the corresponding ages.     

Mortality in Ghana: Evidence from the cape coast project data

This paper deals with the estimation of mortality for a rural community of about 20,000 persons in the rain-forest area of south-west Ghana. Specifically, infant, child and adult mortality estimates have been obtained by the application of a wide range of direct and indirect methods of measuring mortality from the different statistics collected by a longitudinal mortality and fertility project conducted during 1974–7. It was noted that infant and childhood mortality rates obtained from death registrations were consistent with those rates yielded by pregnancy histories and child survival statistics. However, the adult mortality estimates derived from orphanhood statistics tended to be lower than those suggested by death registrations. The analysis revealed an infant mortality rate of 100 for boys and 84 for girls, equal childhood mortality rates for boys and girls (85–6), a lower expectation of life at birth for men (45.8 years) than for women (52.8), and a much more severe incidence of mortality among men aged over 40 than for women at the corresponding ages.     

Infant mortality in the Marshall Islands

Levy and Booth present previously unpublished infant mortality rates for the Marshall Islands. They use an indirect method to estimate infant mortality from the 1973 and 1980 censuses, then apply indirect and direct methods of estimation to data from the Marshall Islands Women's Health Survey of 1985. Comparing the results with estimates of infant mortality obtained from vital registration data enables them to estimate the extent of underregistration of infant deaths. The authors conclude that 1973 census appears to be the most valid information source. Direct estimates from the Women's Health Survey data suggest that infant mortality has increased since 1970-1974, whereas the indirect estimates indicate a decreasing trend in infant mortality rates, converging with the direct estimates in more recent years. In view of increased efforts to improve maternal and child health in the mid-1970s, the decreasing trend is plausible. It is impossible to estimate accurately infant mortality in the Marshall Islands during 1980-1984 from the available data. Estimates based on registration data for 1975-1979 are at least 40% too low. The authors speculate that the estimate of 33 deaths per 1000 live births obtained from registration data for 1984 is 40-50% too low. In round figures, a value of 60 deaths per 1000 may be taken as the final estimate for 1980-1984.     

The measurement of historical trends in fetal mortality in England and Wales

This paper critically discusses recent attempts to estimate long-term trends in the stillbirth rate for England and Wales. It assesses the available historical evidence for the level of late-fetal mortality, drawing especially on examples from Norway, Sweden, and Denmark. A theoretical fetal–infant life table for a high-mortality population is also outlined as a means of analysing the relationship between segments of the conception-to-first-birthday mortality curve. Finally, new estimates of the stillbirth rate for England and Wales are proposed, based on variations in the early neonatal and maternal mortality rates during the 1930s. These estimates are substantially lower than the earlier estimates and are more in keeping with the available evidence from northern Europe. The implications of the revised estimates for interpretations of historical changes in mortality patterns are also considered.     

Estimating infant mortality trends from child survivorship data

Summary Brass's procedure for estimating mortality from census or survey data on numbers of children born to women by age group and numbers of children surviving is generalized to allow the estimation of mortality trends. The new procedure is applied to data for Costa Rica and peninsular Malaysia. The resulting infant mortality rate estimates are compared with rates calculated from vital registration figures. The comparisons suggest, surprisingly, that the estimates derived from statistics for women aged 30-50 are not noticeably inferior to those derived from those for women aged 20-30. This suggests that the common practice of disregarding statistics for women aged over 30 or 35 years may be a mistake. Figures are presented which suggest that estimates based on women aged less than 20 are likely to be very seriously biased because of differential infant mortality by age of mother at birth.     

A reconsideration of negro-white mortality differentials in the united states

This paper summarizes the results of an investigation of the validity of Negro-white mortality differentials as reflected in the series of official United States life tables since the turn of the century. Pertinent excerpts from these often-quoted tables are reproduced in Appendix Table A-1 for convenient reference. The paper divides into two main parts.First, mortality levels and differentials beyond early childhood are derived, without use of the existing vital records, by interpreting the series of ten-year cumulative survival rates implicit in the census records for native whites and for Negroes. The results are in general agreement with the official figures, particularly for males.Second, mortality levels and differentials in early childhood are estimated by extrapolating the official 1)5 values via model life tables; that is, by the analytical procedure that would be followed in the absence of direct information on early childhood mortality. Unless it is assumed that age patterns of death for United States Negroes were extremely deviant from those found in populations with reliable census and vital statistics, one must conclude that the official figures grossly underestimate early childhood mortality for Negroes, at least for the period, 1910-40. It follows that, during those decades, Negro-white mortality differentials in terms of expectation of life at birth were also substantially higher than is suggested by the official estimates.     

Vital rates in India 1961-71 estimated from 1971 census data

Abstract In the last decade the increase in the population of India, while, of course, very large, was smaller than predicted by official forecasts. With the use of recent census and sample registration data - in the absence of age-specific rates and adequate vital statistics - this paper provides estimates of fertility and mortality through the reverse-survival and forward-projection methods. Birth rates are estimated as 40·5-42, death rates as 18-20, and life expectancy at birth as 45-46 years. Mortality decline had been smaller than forecast but more than during any comparable period in the past, even though current mortality levels, particularly infant mortality, are still high. Males continue to have a longer life expectation than females, with a difference that has widened in the past decade. The decline of between seven and ten per cent in the crude birth rate is largely due to changes in marital fertility and to some extent to changes in age and marital composition. Because of greater decline in death rates than birth rates, the 1961-71 decade shows a higher rate of population growth than previous periods.     

The impact of breast feeding patterns on the biometric analysis of infant mortality

A major assumption of the biometric analysis of infant mortality as developed by Bourgeois-Pichat is that the age structure of infant deaths after the first month of life is virtually constant across time and cultures. Reanalysis of results from studies which compare the mortality of infants according to the type of feeding indicated that the relationship between mortality and age within the first year of life followed different patterns for breast fed and artificially fed infants. Historical data for populations with different breast feeding customs reveal similar differences in the age pattern of infant mortality. In populations where breast feeding was uncommon or of very short duration, infant mortality rises particularly steeply during the early months of the first year of life. The age structure of infant mortality in less developed countries where breast feeding is decreasing rapidly may be similarly affected. When substantial deviations from the linear relationship are evident, particular caution is required in applying the biometric technique, since in such situations the estimated endogenous mortality is very much affected by the particular set of data points within the first year of life which are chosen for the basis of the estimates.     

Child mortality in rural India

This paper focuses on infant and child mortality in rural areas of India. We construct a flexible duration model, which allows for frailty at multiple levels and interactions between the child’s age and individual, socioeconomic, and environmental characteristics. The model is estimated using the Indian National Family and Health Survey 1998/1999. The estimation results show that socioeconomic and environmental characteristics have significantly different impacts on mortality rates at different ages. These are particularly important immediately after birth. The parameter estimates indicate that child mortality can be reduced substantially, particularly by improving the education of women, providing safe water, and reducing indoor air pollution caused by dirty cooking fuels. Finally, we still found substantial differences in mortality rates between states, which are associated with differences in schooling expenditures, female immunization, and poverty rates.     

Recent trends in mortality in Australia—an analysis of the causes of death through the application of life table techniques

The paper examines the post-1971 reduction in Australian mortality in light of data on causes of death. Multiple-decrement life tables for eleven leading causes of death by sex are calculated and the incidence of each cause of death is presented in terms of the values of the life table functions. The study found that in the overall decline in mortality over the last 20 years significant changes occurred in the contribution of the various causes to total mortality. Among the three leading causes of death, heart disease, malignant neoplasms (cancer), and cerebrovascular disease (stroke), mortality rates due to neoplasms increased and those of the other two causes decreased. The sex-age-cause-specific incidence of mortality changed and the median age at death increased for all causes except for deaths due to motor-vehicle accidents for both sexes and suicide for males. The paper also deciphers the gains in the expectation of life at birth over various time periods and the sex-differentials in the expectation of life at birth at a point in time in terms of the contributions made by the various sex-age-cause-specific mortality rates.     

Childhood mortality and quality of care among abandoned children in nineteenth-century Italy

A great deal of scholarly attention has been devoted in recent years to the large-scale abandonment of new born babies in the European past, with special emphasis given to the staggering rates of infant mortality among the foundlings. For the most part, scholars have agreed with the foundling home officials of the past in assigning much of the blame for this excess mortality to the women who took in the foundlings as wetnurses and subsequently as foster mothers. This article takes issue with this view, based on an examination of the children abandoned at the foundling home of Bologna, Italy in the nineteenth century. Four cohorts of foundlings are examined - those abandoned in 1809-30, 1829-30, 1849-50, and 1869-70 (N=3615) - as we trace the changing pattern of infant and early childhood mortality. Longitudinal methods are used in examining the life course of these foundlings and the determinants of their mortality.     

Childhood mortality and quality of care among abandoned children in nineteenth-century Italy

A great deal of scholarly attention has been devoted in recent years to the large-scale abandonment of newborn babies in the European past, with special emphasis given to the staggering rates of infant mortality among the foundlings. For the most part, scholars have agreed with the foundling home officials of the past in assigning much of the blame for this excess mortality to the women who took in the foundlings as wetnurses and subsequently as foster mothers. This article takes issue with this view, based on an examination of the children abandoned at the foundling home of Bologna, Italy in the nineteenth century. Four cohorts of foundlings are examined - those abandoned in 1809–30, 1829–30, 1849–50, and 1869–70 (N=3615) - as we trace the changing pattern of infant and early childhood mortality. Longitudinal methods are used in examining the life course of these foundlings and the determinants of their mortality.     

Bridging the gap: Determining long-term changes in infant mortality in pre-registration England and Wales

Much effort has been expended in analysing a small sample of parish registers to produce national estimates of infant mortality for the period 1570–1840. However, in an age when inter-parish variations in infant mortality were considerable, national trends often obscured local and regional differences. By analysing data from the initial years of Civil Registration (1839–1846) together with infant mortality rates from a range of parishes, it is possible to assess the extent of variation and change in England and Wales during the period 1580–1840. The geographical variations in infant mortality and the age structure of infant deaths were sufficient to suggest that the most important influence on whether infants survived was disease environments.     

Paradox found (again): Infant mortality among the Mexican-origin population in the united states

Recent research suggests that the favorable mortality outcomes for the Mexican immigrant population in the United States may largely be attributable to selective out-migration among Mexican immigrants, resulting in artificially low recorded death rates for the Mexican-origin population. In this paper we calculate detailed age-specific infant mortality rates by maternal race/ethnicity and nativity for two important reasons: (1) it is extremely unlikely that women of Mexican origin would migrate to Mexico with newborn babies, especially if the infants were only afew hours or afew days old; and (2) more than 50% of all infant deaths in the United States occur during the first week of life, when the chances of out-migration are very small. We use concatenated data from the U.S. linked birth and infant death cohort files from 1995 to 2000, which provides us with over 20 million births and more than 150,000 infant deaths to analyze. Our results clearly show that first-hour, first-day, and first-week mortality rates among infants born in the United States to Mexican immigrant women are about 10% lower than those experienced by infants of non-Hispanic, white U.S.-born women. It is extremely unlikely that such favorable rates are artificially caused by the out-migration of Mexican-origin women and infants, as we demonstrate with a simulation exercise. Further, infants born to U.S.-born Mexican American women exhibit rates of mortality that are statistically equal to those of non-Hispanic white women during the first weeks of life and fare considerably better than infants born to non-Hispanic black women, with whom they share similar socioeconomic profiles. These patterns are all consistent with the definition of the epidemiologic paradox as originally proposed by Markides and Coreil (1986).     

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.     

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.     

New estimates of the vital rates of the United States black population during the nineteenth century

The difficulties of obtaining credible estimates of vital rates for the black population throughout the entire nineteenth century are overcome in this study. The methodology employed the notion of deviating networks of mortality rates for each general mortality level, which was taken from the United Nations studyThe Concept of a Stable Population. Period life tables and vital rates for intercensal periods were generated from the new estimates of the black population at each census date. The results of this study are highly compatible both with the life tables for the death-registration states in the twentieth century and the recent Coale and Rives reconstruction for the period from 1880 to 1970 and with several estimates of vital rates previously made for the mid-nineteenth century. This study places the mean life expectancy at birth for the black population during the nineteenth century at about 33.7 years for both sexes. The infant death rate (1000m (0)) is shown to have varied between 222 and 237 for females and between 266 and 278 for males. The intrinsic crude death rate centered on 30.4 per thousand during the century, while the birth rate declined from 53.2 early in the century to about 43.8 at the end.     

The measurement of historical trends in fetal mortality in England and Wales

This paper critically discusses recent attempts to estimate long-term trends in the stillbirth rate for England and Wales. It assesses the available historical evidence for the level of late-fetal mortality, drawing especially on examples from Norway, Sweden, and Denmark. A theoretical fetal-infant life table for a high-mortality population is also outlined as a means of analysing the relationship between segments of the conception-to-first-birthday mortality curve. Finally, new estimates of the stillbirth rate for England and Wales are proposed, based on variations in the early neonatal and maternal mortality rates during the 1930s. These estimates are substantially lower than the earlier estimates and are more in keeping with the available evidence from northern Europe. The implications of the revised estimates for interpretations of historical changes in mortality patterns are also considered.     

Some aspects of socio-economic determinants of mortality in tropical Africa

Measurements of mortality levels and trends continue to be inadequate in Africa, largely because of the lack of reliable and adequate information on deaths. A series of estimates depicting mortality levels and trends has been prepared by demographers, different kinds of data and employing different estimation procedures, but knowledge of the "true" structure of mortality in tropical Africa is virtually nonexistent. Because of these problems only a "bird's eye view" of the prevailing situation in tropical Africa is presented. The discussion -- directed to mortality by sex and age, by residence, and by cause -- is based on secondary and fragmentary data. Socioeconomic and cultural determinants of mortality are also examined. Available information on male and female mortality indicates that the death rates for males are higher than they are for females. Early childhood mortality (1-4 years) in tropical Africa is relatively high compared with the other age groups, including infants. Mortality differentials have been noted among geographical and administrative units and subdivisions of populations within the various countries of tropical Africa. Also, urban dwellers enjoy a higher expectation of life at birth than do rural dwellers. Communicable diseases are the main killers in tropical Africa. Persistent poverty and malnutrition, poor housing, unhealthy conditions in the growing cities, nonexistence of health facilities in the rural areas, rapid population expansion, and low levels of education are among the factors impeding progress in reducing mortality in tropical Africa. The need exists to express development goals in terms of the progressive reduction and eventual elimination of malnutrition, disease, illiteracy, squalor, and inequalities. Future trends in mortality in tropical Africa may depend more than they have in the recent past on economic and social development.     

Contribution of mortality decline to longer working life: The case of indonesian males 1980–1995

The length of working life of Indonesian males has been estimated for 1980 and 1995. Data on age specific labour force participation rates are obtained from the 1980 census and the 1995 intercensal population survey. Data on agespecific mortality have been adopted from appropriate model life tables based on indirect estimates of child mortality in the absence of any direct information about mortality. The contribution of declining mortality to the lengthening of working life has been greater than the contribution of higher labour force participation rates. Reductions in mortality at ages before entry into the labour force have increased the potential for added and improved education and training needed for the work force, which is also a contribution of reduced mortality to human capital development. The findings have implications for policy and future employment plans.