Mortality and economic fluctuations

Using wavelet methods, this paper analyzes the relationship between the age-adjusted, infant, and cause-specific mortality rates and the business cycle in Sweden over the period 1800–2000 (1911–1996 for cause-specific mortality). For the period 1800–2000, an increase in GDP by 1% decreased mortality by 0.7%. This overall relationship is due to a strong counter-cyclical relationship in the nineteenth century, which disappeared in the twentieth century. In contrast, in the twentieth century higher mortality in economic upturns is found for mortality caused by circulatory diseases (including stroke) and accidents.     

High-risk families: the unequal distribution of infant mortality in nineteenth-century Sweden

An analysis of infant mortality (based on 133,448 births) in two regions, Sundsvall and Skellefte?, in north-eastern Sweden during the nineteenth century shows that infant mortality was highly clustered with a relatively small number of families accounting for a large proportion of all infant deaths. Using logistic regression, two important factors were found to be associated with high-risk families: (i) a biological component evidenced by an over-representation of women who had experienced stillbirths, and (ii) a social component indicated by an increased risk among women who had remarried. The results strengthen the argument for using the family rather than the single child as the unit of analysis. The clustering of infant deaths points to the need to re-evaluate our interpretations of the causes of infant mortality in the past.     

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.     

Infant Mortality in Nine Industrial Parishes in Northern England, 1813–1836

Evidence about infant mortality in a number of industrial towns was derived from baptismal and burial registers of the Anglican Church. The level of infant mortality during the period 1813–1836, after correction for underregistration, was comparable to that of British towns during the second half of the century. Infant mortality increased during this period, perhaps as a reflection of rapid population growth. In each of the parishes a winter peak and a summer trough was found in the seasonal index of infant deaths during this period. This pattern is very different from the high summer mortality that prevailed in British towns during the late nineteenth century. However, mortality in the summer increased over time, thus reducing the depth of the summer trough in infant deaths, and perhaps represents a movement towards the summer peak so apparent later in the century.     

Socioeconomic Inequalities in Infant Mortality in Egypt: Analyzing Trends Between 1995 and 2014

This paper analyses the trend of the socioeconomic inequalities in infant mortality rates in Egypt over the period 1995–2014, using repeated cross-sectional data from the National Demographic and Health Survey. A multivariate logistic regression and concentration indices are used to examine the demographic and socioeconomic correlates of infant mortality, and how the degree of socioeconomic disparities in child mortality rates has evolved over time. We find a significant drop in infant mortality rates from 63 deaths per 1000 live births in 1995 to 22 deaths per 1000 live births in 2014. However, analyzing trends over the study period reveals no corresponding progress in narrowing the socioeconomic disparities in childhood mortality. Infant mortality rates remain higher in rural areas and among low-income families than the national average. Results show an inverse association between infant mortality rates and living standard measures, with the poor bearing the largest burden of early child mortality. Though the estimated concentration indices show a decline in the degree of socioeconomic inequality in child mortality rates over time, infant mortality rate among the poor remains twice the rate of the richest wealth quintile. Nonetheless, this decline in the degree of socioeconomic inequality in child mortality is not supported by the results of the multivariate logistic regression model. Results of the logistic model show higher odds of infant mortality among rural households, children who are twins, households with risky birth intervals. We find no statistically significant association between infant mortality and child’s sex, access to safe water, mothers’ work, and mothers’ nutritional status. Infant mortality is negatively associated with household wealth and regular health care during pregnancy. Concerted effort and targeting intervention measures are still needed to reduce the degree of socioeconomic and regional inequalities in child health, including infant mortality, in Egypt.     

Infant mortality by Father’s occupation from the 1911 Census of England and Wales

Infant mortality in England and Wales only began its secular decline at the beginning of this century, although mortality among those aged 1-4 began to decline earlier. The 1911 Census of Fertility provides the basis for estimates of infant mortality among occupational groups. A diagrammatic model of decline is elaborated, using fertility decline, social class, income, and urban/rural distribution as explanatory variables. Results of the analysis suggest that infant mortality decline, whose average value was 35 percent from a peak of 132 per 1,000, was increased by improvements in the urban environment and advanced by high or regular income, whereas fertility decline had only a small effect.     

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.     

Further evidence on the decline in infant mortality in pre-industrial England: North Shropshire, 1561-1810

Summary There is growing evidence of a substantial decline in infant mortality in England from the late seventeenth century onwards. This trend is examined in detail using data from the parish registers of a group of rural parishes in North Shropshire. A major change in the whole pattern of first-year mortality during the period 1661-1810 is indicated, its main features being an increase in mortality between the ages of six and eleven months, and a marked fall in mortality during the first three months of life. Examination of the seasonal pattern of infant mortality shows very heavy mortality among young infants in the winter, presumably from respiratory causes, during the period before 1700. It is suggested that a fall in the number of deaths from these causes was the main reason for the decline in infant mortality since the late seventeenth century.     

The global and regional impact of mortality and fertility transitions, 1950-2000

During the second half of the twentieth century, world population grew at a record pace, both in absolute and relative terms, from 2.5 billion to 6 billion (or 1.75 percent annually). Demographers have long identified rapid mortality declines as the main explanation. This article finds that one-fourth of today's world population is alive because of mortality improvements since mid-century. Very rapid growth is unlikely to continue as substantial fertility declines also occurred in recent decades. This article finds that already by the year 2000, these fertility declines have almost exactly compensated for the impact of mortality declines from mid-century levels. This result may suggest homeostasis, but analyses of underlying trends contradict this impression. First, the impact of fertility declines will soon and significantly exceed that of mortality declines. Second, that mortality and fertility declines jointly affect the size of the world population by less than one percent conceals a significant impact on the population's age composition as well as on regional population sizes.     

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.     

Revising Infant Mortality Rates for the Early Twentieth Century United States

Accurate vital statistics are required to understand the evolution of racial disparities in infant health and the causes of rapid secular decline in infant mortality during the early twentieth century. Unfortunately, U.S. infant mortality rates prior to 1950 suffer from an upward bias stemming from a severe underregistration of births. At one extreme, African American births in southern states went unregistered at the rate of 15 % to 25 %. In this study, we construct improved estimates of births and infant mortality in the United States for 1915–1940 using recently released complete count decennial census microdata combined with the counts of infant deaths from published sources. We check the veracity of our estimates with a major birth registration study completed in conjunction with the 1940 decennial census and find that the largest adjustments occur in states with less-complete birth registration systems. An additional advantage of our census-based estimation method is the extension backward of the birth and infant mortality series for years prior to published estimates of registered births, enabling previously impossible comparisons and estimations. Finally, we show that underregistration can bias effect estimates even in a panel setting with specifications that include location fixed effects and place-specific linear time trends.     

Birth Outcome Measures and Infant Mortality

Recent studies have proposed alternative birth outcome measures as means of assessing infant mortality risk; nevertheless, there hasn’t yet been an integrated analysis of these approaches. We review 14 strategies, including various combinations of birth weight, gestational age, fetal growth rate, and Apgar scores—as predictors of early neonatal, late neonatal, and postneonatal mortality, and infant mortality. Using the NCHS linked birth/infant death file for 2001, we construct multivariate logit models and assess the associations between each of the 14 key birth outcome measures and four mortality outcomes. We find that all evaluated birth outcome measures are strong predictors, but Apgar scores are the strongest among all models for all outcomes, independent of birth weight and gestational age. Apgar scores’ predictive power is stronger for Mexican-, white-, and female-infants than for black- and male-infants. Second, all birth outcome measures remain significantly associated with mortality, but their predictive power reduces drastically over time. These findings suggest a rule of thumb for predicting infant mortality odds: when available, Apgar scores should always be included along with birth weight (or LBW status) and gestational age. Additionally, these findings argue for the continued study of low birthweight, gestational age, and Apgar scores as independently salient health outcomes.     

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.     

Spatial Inequality in Mortality in France over the Past Two Centuries

This article analyzes the evolution of spatial inequalities in mortality across 90 French territorial units since 1806. Using a new database, we identify a period from 1881 to 1980 when inequalities rapidly shrank while life expectancy rose. This century of convergence across territories was mainly due to the fall in infant mortality. Since 1980, spatial inequalities have levelled out or occasionally widened, due mainly to differences in life expectancy among the elderly. The geography of mortality also changed radically during the century of convergence. Whereas in the 19th century high mortality occurred mainly in larger cities and along a line from North-west to South-east France, it is now concentrated in the North, and Paris and Lyon currently enjoy an urban advantage.     

The Impact of Family Size on Wealth Accumulation in Rural Thailand

Abstract. We examine the effect of socio-economic covariates on infant mortality in China in the 1980s, particularly the role of previous birth interval and mother's education, using an event history approach with data from the 1988 Two per Thousand Fertility Survey. We use a Bayesian model averaging strategy that takes account of model uncertainty as well as parameter uncertainty. A standard stepwise logistic regression analysis finds no statistically significant relationship between the preceding birth interval and infant survival after controlling for socio-demographic factors, but this finding is reversed when the Bayesian model averaging approach is adopted. However, the method finds less support than a standard stepwise approach for the role of mother's education. We consider the model-fitting criterion of predictive power when applied to out-of-sample observations, and show that Bayesian model averaging outperforms the stepwise approach. We conclude that, even with large sample sizes, the interpretation of results can vary substantially according to model selection and fitting criteria.     

The effects of infant mortality on fertility revisited: new evidence from latin america

In this paper, we examine empirical evidence for a relation between infant and child mortality and fertility in Latin American countries from 1920 to 1990. We investigate the relation at several levels of aggregation and evaluate the extent to which evidence at one level is consistent with evidence at other levels. We first examine aggregate cross-country information over several decades, a type of data typically used in past research on the topic. We also examine yearly series of births, deaths, infant deaths, and socioeconomic indicators for selected countries to track the association between short-term fluctuations in fertility and infant mortality. Finally, we use micro-level data from the Demographic and Health Surveys (DHS) to assess the relation between fertility and child mortality from individual reproductive histories. The evidence we assemble from these different data sets is remarkably consistent and suggests small positive effects of infant mortality on fertility. These effects, however, may be too small to support the hypothesis that changes in child mortality are of more than modest importance in the process of fertility decline in Latin America in the late twentieth century.     

Two and a half centuries of demographic history in a Bavarian village

Abstract A village genealogy containing family histories of couples married between 1692 and 1939 serves as the basis for a study of the demographic history of a Bavarian village. The past patterns of marriage, re-marriage, widowhood, illegitimacy, bridal pregnancy, marital fertility, family size, and birth intervals are examined. Both the age at marriage and illegitimacy increased and then declined during the nineteenth century, apparently in response to changes in restrictive marriage legislation. Differences in fertility for occupational groups were insignificant. Marital fertility remained extremely high before 1900 suggesting the absence of any substantial family limitation within marriage. A rise in marital fertility that occurred during the last half of the nineteenth century appears to result from a change in breast-feeding customs. The actual number of children surviving to maturity for most couples was kept quite low, however, through late marriage and high infant mortality. Only during the twentieth century are substantial declines in infant mortality and fertility evident.     

An Evolutionary Interpretation of Fertility Decline: New Evidence

This article presents new evidence that partly reinforces and partly qualifies the results of a recent article on fertility decline published in this journal by Sanderson and Dubrow. Eight panel regression analyses were carried out, four for the period between 1960 and 1990 and four more for the period of the original demographic transition, that between 1880 and 1940. The analyses for the 1960–1990 period show that Sanderson and Dubrow's original conclusion that infant mortality decline was causing fertility decline (rather than the reverse) was correct. On the other hand, Sanderson and Dubrow's conclusion that enhanced female empowerment led to fertility decline proved incorrect. The new analyses reported here show that the reverse was in fact the case: women became more empowered as a result of declining fertility. The panel analyses carried out for the 1880–1940 period showed that infant mortality decline seemed to be an important cause of fertility decline between 1880 and 1910 but not between 1910 and 1940. However, the reverse hypothesis—that fertility decline caused infant mortality decline during this period—was falsified. I conclude that the causes of fertility decline in the modern world may be different, at least to some extent, from those in the original demographic transition. This is an unsatisfying (because unparsimonious) result that suggests the need for more research.