Socioeconomic status and infant mortality among Hispanics in a southwestern city

Abstract

From data on census tract groupings from Corpus Christi, Texas, for 1979–83, this study shows that, unlike the inverse infant‐mortality‐socioeconomic‐status association observed for Anglos, no such association exists for the Spanish surname population. This finding is discussed in terms of recent research suggesting that the Spanish surname population of the Southwest has lower infant death rates than expected from its generally lower socioeconomic status.     

The relationship between socioeconomic status and infant mortality in metropolitan Ohio, 1999–2001

Abstract

Empirical evidence has consistently documented the direct relationship between infant mortality and socioeconomic inequality in the United States and numerous other countries. While the majority of these studies reveal an inverse relationship between socioeconomic level and infant mortality, not even this finding is free from disagreement. Furthermore, the specific nature and magnitude of this relationship has varied over time.

This study will examine the relationship between socioeconomic status and infant mortality in metropolitan Ohio by using birth and infant death data centered on the 2000 Census. The analyses presented herein will describe and analyze the relationship between infant mortality and socioeconomic status in metropolitan Ohio in the year 2000. The key finding is that in spite of remarkable declines in infant mortality during the past several decades, most notably in neonatal mortality, there continues to be a pronounced inverse association between the infant death rate and the economic status of a population.     

Kuru: An appraisal of five years of investigation

Abstract

Socioeconomic determinants of fertility and mortality were estimated by regression analysis for 29 low‐migration SMSA's located in the eastern part of the U. S. A low‐migration sample was chosen to maximize length of life history within the regions. Independent variables included per cent nonwhite, gross and net migration, population, density, medical care, welfare, per cent Catholic, education, income, and labor force participation. Density was measured by an index based on the census inventory of urban land. Mortality results include effects of migration on older nonwhite life expectancy, an inverse effect of density on life expectancy for older whites, specific income and educational effects on older life expectancies, different causative factors for e(50) and e(1,50), lack of influence of medical care (except for the nonwhite male), and significant infant mortality multiple correlations only for the nonwhite female. For nonwhite fertility, the inverse influences of per cent nonwhite and net migration 1960–70 were of greatest importance. White fertility showed a negative relationship with medical care and a positive one with nonwhite male e(0).     

Heredity of joint diseases

Abstract

This research examines the infant mortality/socioeconomic status relationship in Toledo, Ohio, for the years centering around 19S0, 1960, and 1970 in order to depict variables that contributed most to infant mortality for each time period. Zero‐order correlation coefficients demonstrated that the relationship has widened mainly as a result of an increasing inverse neonatal/socioeconomic pattern which was due in part to a “cause‐period cross‐over effect” (exogenous causes of death were contributing to deaths in the neonatal period in 1970). Further examination suggested that the status variables through which the differentials were operating have shifted from one time period to another. In 1950, crowded housing conditions and unemployment were primarily responsible; in 1960, it was housing and income; and in 1970, marital instability and income predominated. This paper suggests that as new social phenomena emerge they quickly affect sensitive indicators of well‐being such as the infant mortality rate.     

Relationships between pregnancy spacing,sex of infants,maternal age,and birth order,and neonatal and post‐neonatal mortality in Bangladesh

Abstract

The relationships between length of the interpregnancy interval, outcome of the pregnancy preceding the interval, sex of the infants, pregnancy order, maternal age, and maternal history of previous child deaths and neonatal and postneonatal mortality were explored in a rural Bangladeshi population using a multiple regression analysis. Specific interactions between the interpregnancy interval, outcome of the pregnancy preceding the interval, sex of the infants, and history of previous child deaths were examined. An inverse relationship was observed between postneonatal mortality and the length of the interpregnancy interval when the pregnancy preceding the interval was a surviving infant. No such trend was observed for neonatal mortality. Post‐neonatal mortality rates among children whose mothers had experienced two or more previous child deaths were essentially the same as that for infants whose mothers had experienced 0–1 child deaths when the interpregnancy intervals were more than 24 months. Although female infants have a lower neonatal mortality than male infants, the neonatal mortality rate for female infants conceived less than twelve months following a male infant birth was higher than for a male infant conceived less than twelve months following another male infant birth. Post‐neonatal mortality is consistently higher for female compared to male infants in all interval categories.     

Sudden infant death syndrome and the age‐cause proxy relationship in infancy

Abstract

Evidence from a longitudinal study of the relationship between socioeconomic status and infant mortality in metropolitan Ohio is presented in an effort to throw additional light on the continuing debate over the validity of the age‐cause proxy relationship in infancy. The results indicate that while there is a fairly strong and consistent association between neonatal mortality and endogenous causes of death that is little affected by the classification of Sudden Infant Death Syndrome, the nature of the association between postneonatal mortality and exogenous causes of death varies from weak to moderate depending upon where this cause is included. Additional evidence pertaining to the role of SIDS in contributing to the long‐standing inverse association between infant mortality and socioeconomic status is presented, thus further emphasizing the need for continued research to clarify the etiologic mechanisms of this poorly understood condition.     

Racial differences in the relationship between infant mortality and socioeconomic status

This study presents an ecological analysis of the relationship between infant mortality and economic status by race in metropolitan Ohio, using census data on mother's residence and economic status determined by the percentage of low-income families living in each area. The analysis updates previous studies as white-non-white comparisons for total infant mortality are examined for the US censuses of 1960, 1970, 1980, 1990 and 2000; and more detailed period- and broad cause-specific rates are presented for 2000. A pronounced inverse association is consistently found between income status and infant mortality for whites, while for non-whites this pattern first emerges in 1979-81, disappears during the 1980s and then returns more strongly during the 1990s. Similarly, the 2000 data reveal a consistent inverse pattern between income status and infant mortality for white and non-white neonatal and postneonatal death rates, as well as exogenous cause-specific death rates. It is concluded that low-income whites and non-whites have infant mortality rates substantially higher than the overall rate for the population. Policy implications are discussed.     

A methodological note on the relationship between infant mortality and socioeconomic status with evidence from San Antonio, Texas.

A number of previous studies have concluded from social area analyses of medium-size cities that there is no longer a significant correlation between socioeconomic status (SES) and infant mortality in the U.S. To determine if these findings were an artifact of too small samples, the total, neonatal, and postneonatal infant mortality rates were analyzed for 115 census tracts of San Antonio, Texas. The SES of each tract was measured by a score reflecting equally the variables of income, education, and occupation, and allowed assignment of the tracts to 1 of 4 socioeconomic rankings. All 3 infant mortality rates rose as SES decreased, with the most marked relationship being between SES and postneonatal rates. It was also found that of the 3 variables used to measure SES, income bore the strongest relationship to infant mortality. In general it should be noted that social area analysis of infant mortality is limited by the extreme reductions of sample size when additional variables are induced.     

The relationship between socioeconomic status and infant mortality in metropolitan Ohio, 1999-2001

Empirical evidence has consistently documented the direct relationship between infant mortality and socioeconomic inequality in the United States and numerous other countries. While the majority of these studies reveal an inverse relationship between socioeconomic level and infant mortality, not even this finding is free from disagreement. Furthermore, the specific nature and magnitude of this relationship has varied over time. This study will examine the relationship between socioeconomic status and infant mortality in metropolitan Ohio by using birth and infant death data centered on the 2000 Census. The analyses presented herein will describe and analyze the relationship between infant mortality and socioeconomic status in metropolitan Ohio in the year 2000. The key finding is that in spite of remarkable declines in infant mortality during the past several decades, most notably in neonatal mortality, there continues to be a pronounced inverse association between the infant death rate and the economic status of a population.     

Heredity counseling

Abstract

An ecological analysis of infant mortality rates is conducted using data on Texas counties for the years 1968–72. It is found that when counties along the Texas‐Mexico border (which have unreasonably low infant death rates and which are economically less advantaged than the remainder of the counties) are excluded from the analysis, the associations between socioeconomic status variables and infant mortality rates improve considerably. A significant negative correlation between neonatal mortality and per cent Spanish surname is retained and does not disappear when the effects of other relevant variables (per cent Negro, per cent urban, and per cent below poverty) are controlled using partial correlation and regression analysis. Possible explanations for this unexpected finding are suggested, and implications for further research are discussed.     

Reproductive and socioeconomic determinants of child survival: Confounded,interactive, and age‐dependent effects

Abstract

Studies of infant and child mortality have evolved to distinguish between two sets of explanatory variables—factors related to reproductive or maternal characteristics and socioeconomic factors, generally described as characteristics of the family or household. Almost all multivariate analyses include variables from each of these two sets, but there has been little consideration of the relationship between them. We examine how these two sets of variables jointly affect mortality. We test first for confounded effects by examining socioeconomic effects while excluding and then including reproductive variables in nested multivariate models. Next, we look for age‐dependent effects among the explanatory variables and find that reproductive and socioeconomic factors affect mortality at differing ages of children. Finally, we examine interactive effects of the two sets of variables. We conclude that the higher mortality observed among the low status groups is not a result of greater concentration of poor reproductive patterns in those groups. Instead, higher status groups probably have more resources available for combating the negative effects of the same high‐risk reproductive patterns.     

Neighbourhood Characteristics and Long-Term Air Pollution Levels Modify the Association between the Short-Term Nitrogen Dioxide Concentrations and All-Cause Mortality in Paris

BackgroundWhile a great number of papers have been published on the short-term effects of air pollution on mortality, few have tried to assess whether this association varies according to the neighbourhood socioeconomic level and long-term ambient air concentrations measured at the place of residence. We explored the effect modification of 1) socioeconomic status, 2) long-term NO₂ ambient air concentrations, and 3) both combined, on the association between short-term exposure to NO₂ and all-cause mortality in Paris (France).MethodsA time-stratified case-crossover analysis was performed to evaluate the effect of short-term NO₂ variations on mortality, based on 79,107 deaths having occurred among subjects aged over 35 years, from 2004 to 2009, in the city of Paris. Simple and double interactions were statistically tested in order to analyse effect modification by neighbourhood characteristics on the association between mortality and short-term NO₂ exposure. The data was estimated at the census block scale (n=866).ResultsThe mean of the NO₂ concentrations during the five days prior to deaths were associated with an increased risk of all-cause mortality: overall Excess Risk (ER) was 0.94% (95%CI=[0.08;1.80]. A higher risk was revealed for subjects living in the most deprived census blocks in comparison with higher socioeconomic level areas (ER=3.14% (95%CI=[1.41-4.90], p<0.001). Among these deprived census blocks, excess risk was even higher where long-term average NO₂ concentrations were above 55.8 μg/m³ (the top tercile of distribution): ER=4.84% (95%CI=[1.56;8.24], p for interaction=0.02).ConclusionOur results show that people living in census blocks characterized by low socioeconomic status are more vulnerable to air pollution episodes. There is also an indication that people living in these disadvantaged census blocks might experience even higher risk following short-term air pollution episodes, when they are also chronically exposed to higher NO₂ levels.     

Incidence of multiple myeloma in Kailuan cohort: A prospective community-based study in China

BackgroundPrevious retrospective studies showed that the incidence and mortality rates for MM in China were lower than those in western countries. A large-scale prospective study on incidence and mortality rates of MM is still lacking.MethodsBased on the prospective Kailuan Cohort study in China, we included all patients with MM in Kailuan Cohort from June 1, 2008 to December 31, 2016. Using the numbers of diagnosed cases and deaths during the study period as the numerators and the corresponding observed person-years as the denominators respectively, we calculated crude incidence and mortality rates. The 95% confidence intervals for crude incidence rate and mortality rate were estimated base on Poisson distribution. Rates were standardized by direct standardization according to the China population in 2000 and Segi’ world standard population.ResultsA total of 22 members from Kailuan Cohort were first diagnosed with MM between 2008 and 2016. The calculated crude incidence rates were 2.8 (95% CI, 1.7–4.2) per 100,000 person-years for all participants. The standardized incidence rate was 0.9 per 100,000 person-years (95% CI, 0.5–2.1) when standardized by 2000 China population census data, and 1.0 per 100,000 person-years (95% CI, 0.6–1.8) when standardized by Segi’s world standard population (WSP). The calculated crude mortality rates were 2.3 (95% CI, 1.4–3.6) per 100,000 person-years. The mortality standardized by 2000 China population census data was 0.7 per 100,000 person-years (95% CI, 0.3–1.9), and 0.9 per 100,000 population (95% CI, 0.5–1.7) when standardized by Segi’s WSP. Both incidence and mortality for males were higher than that for females almost in all age groups. Both rates increased steadily with age.ConclusionIn this community-based prospective cohort study, we found that the incidence of MM in China was far lower than that in American and Europe.     

Five-year relative survival and determinants of excess mortality in patients with head and neck and thyroid cancers: A population-based study from Golestan province,Northern Iran

BackgroundWe aimed to assess relative survival (RS) and determinants of excess mortality rate in patients with head and neck squamous cell carcinomas (HNSCC) and thyroid cancer in Golestan province, Northern Iran.MethodsWe recruited new primary HNSCC and thyroid cancer cases from Golestan, 2006–2016. Five-year age-standardized RS with their 95% confidence intervals (CIs) were calculated. The relationships between different variables with excess mortality rates were assessed by estimating adjusted excess hazard ratios (aEHRs) with their 95% CIs.ResultsOverall, 718 cases of HNSCC and 386 thyroid cancer cases were enrolled. Five-year age-standardized RS (95% CI) were 36% (31−41) and 61% (52−69) in HNSCC and thyroid cancer patients, respectively. There were significant relationship between excess mortality rates in HNSCC patients with metastasis (aEHR= 3.31; 95%CI: 2.26–4.84), treatment type (4.19; 2.54–6.91, for no treatment as compared to receiving both surgery and chemoradiotherapy), age (2.16; 1.57–2.96, for older age group) and smoking (2.00; 1.45–2.75, for smokers as compared to non-smokers). Determinant of the excess mortality in thyroid cancer patients included metastasis (19.65; 8.08–47.79), tumor morphology (12.27; 4.62–32.58, for anaplastic cancer as compared to papillary cancer), treatment type (8.95, 4.13–19.4, for no treatment as compared to receiving both surgery and iodine therapy) and age (2.31; 1.17–4.54, for older age group).ConclusionOur findings suggested low RS for thyroid cancer in our population, while the estimates for HNSCC were comparable with other population. Metastasis, treatment type and age were determinants of mortality both in thyroid and HNSCC patients.     

Nominations sought for Mindel C. Sheps Award

Abstract

The relationship between early fetal wastage or stillbirth and pregnancy spacing was examined in a population characterized by prolonged lactation, minimal nutrition, and high fertility and mortality. The highest risk of early fetal death was found among those pregnancies conceived less than twelve months after the birth of a surviving breast‐fed infant. Lactation as a possible causal factor is discussed. A significant inverse relationship was apparent for second trimester fetal deaths and pregnancy intervals, but not for third trimester deaths. This finding is surprising when one considers that fetal weight gain, and presumably nutrient demand, increases most rapidly during the third trimester.     

Educational inequalities in cancer incidence and mortality in Lithuania: A record linkage study

BackgroundThe aim of this study is to describe associations between incidence and mortality by major cancer sites and education in Lithuania.MethodsThe study is based on the linkage between all records of the 2001 population census and all records from Lithuanian Cancer Registry (cancer incidence) and Statistics Lithuania (deaths) for the period between 1 July 2001 and 31 December 2004. Education-specific incidence and mortality rate ratios were estimated by means of multivariate Poisson regression models.ResultsWe found both the positive and inverse educational gradients in cancer incidence and mortality. The risk of developing cancer (all sites) was lower among men and women with the lowest education, whereas cancer mortality was higher among lower educated men. The higher educational level was also associated with an increased risk of prostate cancer among men and an increased risk of breast cancer among women. However, prostate cancer mortality was the highest in the lowest education group, whereas breast cancer mortality among women did not show any statistically significant differences. Lower educated men had significantly higher incidence and mortality due to lung and stomach cancers. Strikingly high incidence and mortality due to cervix cancer was observed among women with secondary and lower than secondary education.ConclusionThe results point to inequalities in early diagnosis and survival from cancer and failures ensuring equal access to medical care. Further more in-depth studies are needed in order to understand the nature and determinants of these inequalities.     

Socioeconomic status and infant mortality among Hispanics in a southwestern city

Recent investigations of infant mortality in the Southwest part of the US have shown that Spanish surname infant death rates are lower than might be expected from the relatively low socioeconomic standing of the Spanish surname population, a phenomenon that appears to be confined to the neonatal componont of the infant mortality rate. The relationship between socioeconomic status (ses) and infant mortality is examined overall and separately within the Anglo and Spanish surname populations of Corpus Christ, Texas. The investigation utilizes data from the 36 Nueces County census tracts. Most recent data on infant, neonatal, and postneonatal mortality was provided by the local health department. Subjects were limited to Anglos and those whites with at least 1 Spanish surname parent. The 1979-1983 cohort is analyzed. Information from the 1980 US census was utilized to divide the 36 census tracts into 3 SES groups: high, medium and low. The most immediately striking aspect of the findings is the significant inverse gradient in Anglos between SES and both the total infant mortality rate (IMR) and the neonatal mortality (NMR), a gradient which is nonexistent in the Spanish surname population as well as overall. In addition, Anglos and Spanish persons differ significantly with respect to all IMRs and NMRs. In the high and medium SES groups and overall, all Anglo rates are lower, while in the low SES group, Spanish surname rates are lower. These findings suggest that, among Anglos, SES is a crucial factor in infant deaths, whereas, among the Spanish surname population, having a medium or high SES does not offer any additional protection against mortality. Alternatively, lower SES does not translate into significantly lower infant mortality among Spanish persons. These findings provide support for the study's hypotheses that the SES-infant mortality association is weaker among Spanish persons than among Anglos. The analysis also shows the importance of analyzing the SES-infant mortality association separately by ethnicity. Studies in larger cities and also studies utilizing matched birth and death records are needed to further elaborate these findings.     

Breast‐feeding,social variables,and infant mortality: A hazards model analysis of the case of Malaysia

Abstract

This study is an attempt to use a hazards model to estimate the relative risks of mortality experienced at different periods during the first year of life among Malaysian infants breast‐fed for various durations. Data on mortality, breast‐feeding, and social variables were obtained from the retrospective Malaysian Family Life Survey and were used after checking for quality and consistency. Using LOGLIN to calculate hazards models, essentially multidimensional life‐tables, we found that breast‐feeding had an effect on mortality independent of socio‐economic variables and birth cohort. There was a monotonic relationship between breastfeeding duration and lower infant mortality during each of four subdivisions of the first year of life. Breast‐feeding was a statistically significant predictor of mortality in the first six months. The results are compared with those from the Rand study, which employed regression rather than hazards models.     

Hereditary susceptibility in rheumatic fever

Abstract

The authors criticize past studies for concluding that the relationship between socio‐economic status and infant mortality has declined in modern industrial societies to the degree that it is almost nonexistent. Such studies computed infant death rates utilizing small numbers of births and deaths, resulting in unreliable rates. In this study, social area analysis is employed in a fairly large city with vital data from the early 1970's. The findings indicate a rather strong relationship still exists between SES and infant mortality. Limitations of social area analysis are discussed, and suggestions for future research are given.     

Childhood leukemia mortality and farming exposure in South Korea: A national population-based birth cohort study

ObjectivesThe aim of this study was to evaluate the relationship between leukemia mortality and exposure to farming among children in South Korea.MethodsA retrospective cohort study of South Korean children was conducted using data collected by the national birth register between 1995 and 2006; these data were then individually linked to death data. A cohort of 6,479,406 children was followed from birth until either their death or until December 31, 2006. For surrogate measures of pesticide exposure, we used residence at birth, paternal occupation, and month of conception from the birth certificate. Farming and pesticide exposure indexes by county were calculated using information derived from the 2000 agricultural census. Poisson regression analyses were used to calculate rate ratios (RRs) of childhood leukemia deaths according to indices of exposure to agricultural pesticides after adjustment for potential confounders.ResultsIn total 585 leukemia deaths were observed during the study period. Childhood leukemia mortality was significantly elevated in children born in rural areas (RR = 1.43, 95%CI 1.09–1.86) compared to those in metropolises, and in counties with both the highest farming index (RR = 1.33, 95%CI 1.04–1.69) and pesticide exposure index (RR = 1.30, 95%CI 1.02–1.66) compared to those in the reference group. However, exposure–response associations were significant only in relation to the farming index. When the analyses were limited to rural areas, the risk of death from leukemia among boys conceived between spring and fall increased over those conceived in winter.ConclusionsOur results show an increase in mortality from childhood leukemia in rural areas; however, further studies are warranted to investigate the environmental factors contributing to the excess mortality from childhood leukemia in rural areas.