Inequality in Infant Mortality Among Population of Modern Russia

2020 ◽  
Vol 27 (2) ◽  
pp. 48-62
Author(s):  
E. M. Andreev

Based on official statistics, the author tries to address the question of why the infant mortality rate in Russia is significantly higher than might be expected given the measures taken to protect the health of pregnant women and newborns. In the introduction, the author explains the relevance of studying inequality in the level of infant mortality among the population of modern Russia as a factor holding back the positive downward trend.After presenting the latest history of the evolution of the information and statistical base for population studies on the subjects under review, the author confirms the approach according to which it is advisable to work with data for real generations when analyzing the differentiation of infant mortality and generations born in 2014-2016 are chosen as the object of analysis.To determine the relevance of individual factors contributing to infant mortality, the author cross-tabulated raw data. Data on such initial characteristics (factors) as the birth order of the child, whether a mother is in a contracted civil marriage or not, mother’s level of education, were grouped by age groups of mothers. The use of cross-tabulation allowed to affirm not only the influence of individual factors on the level of infant mortality but also a quantitative differentiation between them. The article concludes the extent to which the overall level of infant mortality is determined by mortality rates from individual causes of death.A significant part of the article is presented in the format of author generalization using statistical methods regarding the educational differences of mothers, which have become differentiation factors in infant mortality rates.The socio-demographic analysis based on official statistics has confirmed not only some hypotheses as to why, despite the relatively rapid decrease in infant mortality in Russia in recent years, its level remains higher than in almost all European countries with reliable demographic statistics, but also to reveal the extent of the inequality of infant mortality in our country.The author argues that the reason why Russia lags behind many countries with the positive downward infant mortality trend is strongly associated with causes of death from conditions arising in the perinatal period as well as congenital disorders. This suggests that the level of medical care for pregnant women and newborns in Russia is still lower than in developed European countries. It also has to be assumed that different educational groups have unequal access to quality health care. А proactive approach to life as well as a progressive achievement of the right to choose a medical institution and a doctor - is one of the important directions for resolving a whole set of national health care issues.

2011 ◽  
Vol 19 (4) ◽  
pp. 977-984 ◽  
Author(s):  
René Mauricio Barría-Pailaquilén ◽  
Yessy Mendoza-Maldonado ◽  
Yohana Urrutia-Toro ◽  
Cristian Castro-Mora ◽  
Gema Santander-Manríquez

The aim of the study was to assess the trend of the infant mortality rate between 1990-2004 and the neonatal mortality between 2000-2005 in infants born at less than 32 weeks of gestational age or with very low birth-weight. Based on secondary data, infant mortality rate and by its component for Valdivia city were compared with national indicators. Mortality at <32 weeks and <1500g was calculated, establishing causes of death and evaluating its relation with specific interventions, such as the use of surfactant and antenatal corticoids. Since the year 2000, infant mortality rates have stopped their decrease in comparison to the preceding decade and the gap between national and local rates before 2000 was drastically reduced. Mortality at <32 weeks and <1500g varied between 88‰ and 200‰ of liveborns, emphasizing respiratory distress as the main cause of death. The use of corticoids and surfactant was in line with reductions in mortality rates.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A B Guerra ◽  
L M Guerra ◽  
L F Probst ◽  
B V Castro Gondinho ◽  
G M Bovi Ambrosano ◽  
...  

Abstract Background The state of São Paulo recorded a significant reduction in infant mortality, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality and maternal mortality in the state of São Paulo, Brazil. Methods In this ecological study, data from national official open sources were used. Analyzed were 645 municipalities in the state of São Paulo, Brazil. For each municipality, the infant mortality and maternal mortality rates were calculated for every 1000 live births, 2013. The association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. We used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted “p” at 5%. Results The increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates. Conclusions It was concluded that the Family Health Care Strategy model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model. Key messages Implementation of public policies with specific focus on attenuating these factors and making it possible to optimize resources, and not interrupting the FHS. Knowledge of the factors with impact on these indicators would be of help in formulating public policies.


2018 ◽  
Vol 36 (08) ◽  
pp. 798-805 ◽  
Author(s):  
Han-Yang Chen ◽  
Suneet P. Chauhan

Objective To compare neonatal and infant mortality rates stratified by gestational age (GA) between singletons and twins and examine the three leading causes of death among them. Study Design This was a retrospective cohort study using the U.S. vital statistics datasets. The study was restricted to nonanomalous live births at 24 to 40 weeks delivered in 2005 to 2014. We used multivariable Poisson regression models with robust error variance to examine the association between birth plurality (singleton vs. twin) and mortality outcomes within each GA, while adjusting for confounders. The results were presented as adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). Results Of 26,292,747 live births, 96.6% were singletons and 3.4% were twins. At 29 to 36 weeks of GA, compared with singletons, twins had a lower risk of neonatal mortality (aRR: 0.37–0.78) and infant mortality (aRR: 0.54–0.86). When examined by GA, the three leading causes of neonatal and infant mortality varied between singletons and twins. Conclusion When stratified by GA, the risk of neonatal and infant mortality was lower at 29 to 36 weeks in twins than in singletons, though the cause of death varied.


2019 ◽  
Vol 72 (5) ◽  
pp. 1136-1139
Author(s):  
Tetiana V. Pluzhnikova ◽  
Oksana I. Krasnovа ◽  
Svitlana S. Kasinets ◽  
Svitlana M. Tanyanskaya ◽  
Natalia V. Yaroshenko ◽  
...  

Introduction: Providing high-quality health care to the newborn is part of the national health system. The number of healthy children in Ukraine decreases annually. One of the main directions of development of the pediatric service is reduction of indicators of child mortality, increase of birth rate and strengthening of children’s health. The aim: To analyze the dynamics of morbidity and causes of infant mortality in the city of Poltava. Materials and methods: Medical and statistical - for collecting, processing and analyzing data, (descriptive and analytical statistics for determining relative indicators, absolute growth indicators), a systems approach and system analysis. Review: According to a study in the city of Poltava, there is a negative absolute increase in the birth rate of children. In the structure of the causes of death of the child population in the first place are the diseases of the period of birth of the newborn, in the second place - congenital anomalies of development. The third place in the structure of causes of death is occupied by diseases of the central nervous system. There is a clear decrease in the incidence of hemolytic disease, anemia, cardiac disorders, intrauterine hypoxia and asphyxiation. In the structure of birth injuries in newborns occupy closed clavicle fractures, plexitis of the newborn. Conclusions: Analysis of the incidence and causes of infant mortality in the city of Poltava suggests that in recent years there has been a decrease in fertility rates, an increase in morbidity rates. The reform should be aimed at improving the state of the pediatric service and the prevention of preterm labor.


2008 ◽  
Vol 40 (2) ◽  
pp. 183-201 ◽  
Author(s):  
PERIANAYAGAM AROKIASAMY ◽  
ABHISHEK GAUTAM

SummaryIn India, the eight socioeconomically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh, referred to as the Empowered Action Group (EAG) states, lag behind in the demographic transition and have the highest infant mortality rates in the country. Neonatal mortality constitutes about 60% of the total infant mortality in India and is highest in the EAG states. This study assesses the levels and trends in neonatal mortality in the EAG states and examines the impact of bio-demographic compared with health care determinants on neonatal mortality. Data from India’s Sample Registration System (SRS) and National Family and Health Survey (NFHS-2, 1998–99) are used. Cox proportional hazard models are applied to estimate adjusted neonatal mortality rates by health care, bio-demographic and socioeconomic determinants. Variations in neonatal mortality by these determinants suggest that universal coverage of all pregnant women with full antenatal care, providing assistance at delivery and postnatal care including emergency care are critical inputs for achieving a reduction in neonatal mortality. Health interventions are also required that focus on curtailing the high risk of neonatal deaths arising from the mothers’ younger age at childbirth, low birth weight of children and higher order births with short birth intervals.


PEDIATRICS ◽  
1992 ◽  
Vol 90 (6) ◽  
pp. 835-845
Author(s):  
Myron E. Wegman

Between 1990 and 1991, provisional data show that the infant mortality rate decreased again, from 9.1 to 8.9, a decline of 2% in contrast to the 7% decline from 1989 to 1990. Birth, death, and marriage rates were also lower, but the divorce rate stayed at about the same level as in 1990. Natural increase in the population, excess of births over deaths, was less than 2 million, 4% less than the increase in 1990. Detailed analysis of changes and of the influence of factors like age and race requires final data; at the time of preparation of this report final birth and death data were available only through 1989. For a variety of reasons, including staff shortages and delays in receipt of state data by the National Center for Health Statistics (NCHS), final data for 1990, which would usually have been available in late August 1992, are not expected before early 1993. Unlike recent years, the decline in the infant mortality rate was only in the neonatal component, which decreased 3.6%. Postneonatal mortality increased, for the first time in many years, by 1.6%, suggesting that the decline in the total is related more to therapeutic advances in neonatology than to improved prevention. Internationally, newly independent Latvia was added to the list of countries with rates less than 15, but Costa Rica was deleted. With the reunification of Germany the list shrank to 28 and, by default, the United States moved up from 21st to 20th. Some 12.5 million births, less than 9% of the world total, took place in countries with under-5 mortality rates of less than 20 per 1000. At the other end of the scale, 42% of the world's births occurred in countries with under-5 mortality rates of more than 140 per 1000. The median under-5 mortality rate for those countries in 1990 was 189 per 1000, meaning that almost 20% of the infants born alive in these countries died before their fifth birthday.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 792-803 ◽  
Author(s):  
Myron E. Wegman

A new low in the infant mortality rate was reached again in 1993, at 828.8 deaths per 100 000 live births, a decline of 2% from 848.7 in 1992. Births, marriages, and divorces were all lower, both in number and rate. Deaths and the death rate, however, both increased and, more significantly, the age-adjusted death rate increased. A likely explanation is the occurrence of influenza epidemics in early and late 1993. The rate of natural increase declined 8%, to a level of 6.9 per 1000 population. Final figures on births for 1992 indicate that, for the first time in many years, birth rates to teen-agers declined, more among black mothers than white. Increase in birth rate among older mothers continued at a somewhat slower rate than recently; older mothers tended to be better educated than the general population in their age groups. Total fertility rates were higher among mothers of Hispanic origin than among non-Hispanic blacks who, in turn, had higher rates than non-Hispanic whites. Among Hispanics the highest rates were in those of Mexican origin. Unlike recent years, birth rates to unmarried mothers did not increase in 1992. Prenatal care coverage improved, with more mothers seeking care early and fewer receiving late or no care. Electronic and fetal monitoring was performed on more than three-quarters of all births and ultrasound on more than half. Life expectancy decreased slightly, in contrast to recent years. Among major causes of death, increases were recorded in 1993 for chronic obstructive pulmonary diseases, pneumonia and influenza, and HIV infection, the latter having the largest percentage increase. Internationally, infant mortality rates in most other industrialized countries declined further in 1992. Comparatively, as in 1991, 21 other countries had infant mortality rates lower than the United States.


2019 ◽  
Vol 48 (Supplement_1) ◽  
pp. i54-i62 ◽  
Author(s):  
Ana M B Menezes ◽  
Fernando C Barros ◽  
Bernardo L Horta ◽  
Alicia Matijasevich ◽  
Andréa Dâmaso Bertoldi ◽  
...  

Abstract Background Infant-mortality rates have been declining in many low- and middle-income countries, including Brazil. Information on causes of death and on socio-economic inequalities is scarce. Methods Four birth cohorts were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, each including all hospital births in the calendar year. Surveillance in hospitals and vital registries, accompanied by interviews with doctors and families, detected fetal and infant deaths and ascertained their causes. Late-fetal (stillbirth)-, neonatal- and post-neonatal-death rates were calculated. Results All-cause and cause-specific death rates were reduced. During the study period, stillbirths fell by 47.8% (from 16.1 to 8.4 per 1000), neonatal mortality by 57.0% (from 20.1 to 8.7) and infant mortality by 62.0% (from 36.4 to 13.8). Perinatal causes were the leading causes of death in the four cohorts; deaths due to infectious diseases showed the largest reductions, with diarrhoea causing 25 deaths in 1982 and none in 2015. Late-fetal-, neonatal- and infant-mortality rates were higher for children born to Brown or Black women and to low-income women. Absolute socio-economic inequalities based on income—expressed in deaths per 1000 births—were reduced over time but relative inequalities—expressed as ratios of mortality rates—tended to remain stable. Conclusion The observed improvements are likely due to progress in social determinants of health and expansion of health care. In spite of progress, current levels remain substantially greater than those observed in high-income countries, and social and ethnic inequalities persist.


Author(s):  
Funda Kara ◽  
İrfan Ersin

There is a positive relationship between the health level of the society and its economic development. The main reason is that improving quality of the lives and increasing lifetime has lead to higher economic performance. This evaluates the relationship between health expenditure and infant mortality rate in OECD countries. In the analysis process, 20 different countries in the OECD are selected and annual data of these countries for the years between 1980 and 2017 is evaluated with the help of Kao panel cointegration and Dumitrescu-Hurlin causality analysis. The findings show that there is long term relationship between health expenditure and infant mortality rates in OECD countries. Another important conclusion is that there is a causality analysis from health expenditure to the infant mortality rate. While considering these results, it is recommended that OECD countries should take some actions in order to increase health expenditure so that it can be possible to decrease infant mortality rate.


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