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PubMedDate not supplied

Women's status and infant mortality in rural Colombia.

This paper investigates the effects of maternal demographic characteristics and social and economic statuses on infant mortality in rural Colombia. Demographic characteristics include the age of the mother, parity and length of preceding interbirth interval, and sex of infant. Measures of women's status at the time of birth include education, wage labor and occupation, economic stratum, place of residence, and whether the mother is living with a husband. The life history data for the study (involving 4,928 births) were collected in 1986 from a representative sample of two cohorts of women resident in rural central Colombia. Overall differentials in infant mortality by measures of women's status are small and are in good part associated with the differing reproductive behaviors of the women and variations in breastfeeding practices. The sharp declines in infant mortality recorded in rural Colombia in recent years appear less related to improved status of women than to reductions in fertility that enhance infant survivorship and to public health interventions shared by all segments of the population.

Adult↗
PubMedDate not supplied

Regional variation in infant survival in China.

From retrospective survey reports 1985-87, the study examined the determinants of neonatal and post-neonatal survival in three provinces in China. Conditional logistic regression models were employed to estimate the effects of macro- and micro-level factors (such as socioeconomic conditions, familial relationships, as well as biosocial determinants) on the survivorship of neonatal and post-neonatal infants in China. The study yielded two findings: (1) Social changes in Chinese society had a strong positive effect on neonatal and post-neonatal survivorship; and (2) the magnitude of such social changes differed across regions which, in turn, led to the differential effects on neonatal and post-neonatal survivorship across provinces in China.

China↗
PubMedDate not supplied

Risk of mortality following widowhood: age and sex differences by mode of death.

This study examines how spouses' deaths from sudden or lengthy illnesses differentially affect the mortality risks of surviving widows and widowers by age. Using the Panel Study of Income Dynamics, we find the mortality risk differs by gender, age, and type of widowhood. For nonelderly (< 65) widowers, there is an elevated risk when their wives died suddenly. For older (> or = 65) widows, the mortality risk is lower than that of comparably aged married women when their husbands died after a long-term illness. These gender, age, and mode-of-death differences are consistent with role theory and theories of social support.

Adult↗
PubMedDate not supplied

Effects of sociodemographic variables on adult mortality in the United States: comparisons by sex, age, and cause of death.

The effects of sociodemographic variables on mortality for U.S. adults are estimated, using data from the National Health Interview Survey matched with National Death Index data. Dependent variables of the proportional hazards models include all-cause mortality and mortality due to circulatory disease, lung cancer, breast cancer, other cancer, other medical causes, and nonmedical causes. Results indicate that all of the sociodemographic variables (education, income, employment status, marital status, race) have independent effects on all-cause mortality, with similar-effect sizes for males and females, and weaker effects in the older group (ages 65+) than the younger (ages 25-64). For the separate causes of death, the effects of most sociodemographic variables vary by sex.

Adult↗
PubMed1989

Epidemiology and cause of deaths among women in rural Bangladesh.

A total of 542 women aged 15 to 44 years died during the 10-year period 1976 to 1985 in the control area of Matlab, an area with a population of 90,000, representative of many other rural areas of southern Bangladesh. The corresponding age-specific mortality rate was 290 per 100,000 women 15-44 years. These deaths have been analysed retrospectively, using information collected through the Demographic Surveillance System set up by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and verbal autopsies conducted in the homes. Of these deaths, 175 (32%) were due to infectious diseases, 163 (30%) to direct obstetric complications, 67 (12%) to injuries, and the remaining 26% to other causes. Cause-specific and proportionate mortality rates showed a positive association with age for deaths due to infectious diseases, non-infectious diseases and unspecified causes, and an inverse association with age for deaths due to injuries. These rates showed a peak in the intermediate age group 25 to 34 years for deaths due to direct obstetric causes. No consistent trends were visible when annual rates were studied over time. Prior to death, 42% of the women were attended by traditional practitioners, and 33% were not attended at all. Demographic impact is discussed, emphasizing the contribution of obstetric causes to overall mortality. Priorities for health policy implications are proposed, focusing upon a strong maternity care programme, and improved availability of female health personnel, in the context of the socio-cultural constraints imposed on women in poor rural areas.

Adolescent↗
PubMed1991

Another look at the black-white gap in gestation-specific perinatal mortality.

In the US, black infants born near or at term experience higher mortality than white infants. To extend our understanding of black-white differences in the relative advantages of growth (measured by birthweight) for gestational age, we compared race-specific rates of perinatal mortality by deviation in grams from the median birthweight for four categories of gestation (35-36, 37-38, 39-41, and 42-43 weeks). We also used race-specific standards to examine the difference between the median birthweight and the optimum birthweight (i.e. birthweight with the lowest mortality). The data, which were derived from vital records for singletons delivered in the US from 1983-1984, comprised 24,626 fetal and neonatal deaths among 5,157,197 white infants and 5973 fetal and neonatal deaths among 926,678 black infants. At all deviations from the median birthweight, black infants had relatively better survival at 35-36 weeks of gestation. This advantage was reversed among infants with gestations of 39-41 and 42-43 weeks. The optimum birthweight for black infants with gestations greater than or equal to 37 weeks was closer to their median birthweight than was that for white infants. For black infants with gestations of 39-41 weeks, the optimum birthweight was 187g (95% confidence interval (CI): 150-234) greater than the median birthweight (3289g); for comparable white infants the optimum birthweight was 397g (95% CI: 366-431) greater than the median birthweight (3487g). To reduce the black-white gap in perinatal mortality, we need a better understanding of aetiological relations between gestation, growth, and mortality.

Birth Weight↗
PubMed1992

Early childhood mortality in a Brazilian cohort: the roles of birthweight and socioeconomic status.

The deaths of children aged 1-4 years were studied in a cohort of 5914 Brazilian liveborns. A total of 29 early childhood deaths were recorded (cumulative mortality risk of approximately 6 per 1000), 17 of which (59%) were due to infectious diseases. The death rate was highest in the second year. Deaths were highly concentrated in children from low income (< US $50/month) families, where the cumulative risk of early childhood death was about 10 per 1000; on the other hand, there were no deaths among the 616 children from families with a monthly income of US $300 or more. Birthweight was also associated with mortality: the cumulative risk of children weighing less than 2000 g at birth was 21 per 1000, compared to 4 per 1000 among those with birthweights of 3500 g or more. Simultaneous adjustment for income and birthweight did not substantially change these differentials. These findings confirm the strong association between early childhood mortality and socioeconomic conditions, but also make evident the long-term effects of low birthweight.

Birth Weight↗
PubMed1994

Mortality among Icelandic seamen.

BACKGROUND: The aim of this cohort study was to evaluate the mortality of Icelandic seamen with particular reference to cancer deaths. SUBJECTS: In all 27,884 seamen, both fishermen and sailors of the merchant fleet, who had been members of a pension fund between 1958 and 1986 were followed-up. RESULTS: Most standardized mortality ratios (SMR) were greater than 1:1.26 for all causes, 1.13 for all malignant neoplasms, 1.80 for liver cancer, 1.19 for stomach cancer, 1.56 for lung cancer, and 1.21 for kidney cancer. The highest SMR was found for unknown causes, 3.16. There was no 'healthy worker effect'. For most causes of death latency time and mortality were strongly correlated. When analysing the relation between duration of employment and mortality a correlation was found for all-causes and for stomach cancer; however, this was not statistically significant. CONCLUSION: Seamen have an unusual mortality pattern and the excess for unknown causes is a rare finding indicating a peculiar situation for this group. The excess of stomach and lung cancer was high but it was not convincingly related to duration of employment and thus a relationship to occupation cannot be confirmed.

Adult↗
PubMed1996

Maternal mortality in England and Wales 1970-1985: an analysis by country of birth.

OBJECTIVE: To determine the risk of maternal mortality in immigrants to England and Wales. DESIGN: Analysis of death registrations, 1970-1985, by country of birth. SETTING: England and Wales. POPULATION: Women dying in England and Wales during pregnancy, childbirth or the puerperium, or dying from malignant tumour of the placenta. MAIN OUTCOME MEASURES: The risk of dying in pregnancy, childbirth or the puerperium, adjusted for age and year of death, and the risk of cause-specific death, adjusted for age, in immigrants compared with women born in England and Wales. RESULTS: Women born in West Africa (relative risk 10.3; 95% CI 8.0-13.2) and the Caribbean (4.6; 3.8-5.7) were at very elevated risk of maternal death and of the main causes of death. Women from Southern Asia (1.6; 1.3-2.0) and "Europe and the USSR' (1.7; 1.2-2.3) were at moderate risk. Adjustment for year of death increased the estimates of risk and women born in the "Rest of the World' and Scotland were at significantly elevated risk. CONCLUSIONS: An increased incidence of obstetric conditions in immigrant groups may account for the elevated risk but it is also possible that differences in care may account for some of the additional risk. The pattern of increased risk does not appear to be explicable by the parity or social class distribution of immigrants as far as data are available on these. Research is required into the aetiology of the differential incidence of obstetric disease. The collection of routine mortality data which include maternal reproductive and social factors would elucidate the significance of such factors to maternal health. Further investigation into possible differences in the process of antenatal care between immigrants and non-immigrants is required, and into whether this affects the risk of maternal mortality.

Adult↗
PubMed1994

Nutrition of the Asian adolescent girl.

A comparison of sex differential mortality rates indicates that women are at increased risk in several countries of Asia, in part due to less access to a variety of services and lower priority for food than their male siblings. Poorer nutritional status becomes apparent during adolescence, with a delay in maturation which may have repercussions for subsequent ability of the biologically immature woman to carry through a normal pregnancy. There is a dearth of information on girls during this vulnerable period of life which is recently being corrected by studies in Nepal, India and the Philippines where the magnitude of dietary risk is being compared with its impact on nutritional status and the sociocultural factors that may be responsible.

Adolescent↗
PubMed1992

Patterns of demographic change in the Americas.

Considerable scholarly debate has focused on the nature of demographic change in the Americas before and after 1492. Recent research on human skeletal samples and related archeological materials suggests that morbidity and mortality were increasing throughout much of the Western Hemisphere before 1492 in response to increased population density, increased sedentism, and changing subsistence. The evidence suggests that after 1492 population reduction was caused not by continental pandemics but by localized or regional epidemics augmented by social and economic disruption. The twentieth century has witnessed remarkable Native American population recovery, fueled both by improvements in health care and changing definitions of "being Indian."

Disease Outbreaks↗
PubMedDate not supplied

[Fertility and health in Mexico].

Fertility, health, and family planning are not independent factors, but rather involve a series of biological and social mechanisms in close interaction with one another. The impact that a high fertility rate has on health is reflected mainly in a rise in the rates of maternal and child mortality. Similarly, fertility has a greater negative effect upon the health of groups characterized by high reproductive risk, high parity, short intergenesic intervals, and unwanted pregnancies. On the other hand, family planning -and specifically the use of contraceptive methods-helps to achieve a lowering of the fertility rate and also has a positive effect on maternal-child health. This situation can be observed in the case of Mexico, where fertility rates and tendencies, as well as maternal and child mortality, have been reduced during the past decade.

Family Planning Services↗
PubMed1994

Neonatal and post-neonatal mortality in the Galle district.

OBJECTIVE: To determine some factors associated with infant mortality. DESIGN: Descriptive study. SETTING: Galle district in Sri Lanka. SUBJECTS: 350 infant deaths of singleton births. MEASUREMENTS: Association between variables. RESULTS: Neonatal:post-neonatal death ratio was 3.2:1, and 62.3% (218) were early neonatal deaths. First day deaths comprised 28.6% (100); 67.8% (237) died at the Teaching Hospital. A high incidence (65.7%) of low birthweight (LBW) was noted. Mean birthweights of neonates and post-neonates were 1925 +/- 729 and 2520 +/- 620 gram respectively, and the difference between means was statistically significant (p < 0.001). LBW and related disorders were the major cause of death in 44% (154) of the total sample, and in 55.8% (149) of neonates. Infections were the commonest cause (55.8%) of death in post-neonates. Pediatric clinical assessment to differentiate small-for-dates (SFD) was not recorded in 90.3%. Statistically significant associations were found between the period of death (neonatal and post-neonatal) and the following variables: period of gestation (p < 0.001); birthweight (p < 0.001) and cause of death (p < 0.001). CONCLUSIONS: There was a high incidence of neonatal deaths and a high proportion of early neonatal deaths. About one-third of deaths occurred on the first day of life. Incidence of LBW was high. The major cause of death was LBW and related disorders in the total sample and in neonates. Assessment of SFD was not carried out in the vast majority of infants.

Cause of Death↗