Inequalities in Infant Survival: An Analysis of Czech Linked Records

摘要

This research analysed individual linked infantbirth and death records for the Czech Republicfor the years from 1986 to 1992. The studyfocused on differences in the risk of infantdeath in a former socialist country whereconditions were relatively egalitarian andhealth care was free. The key variablesanalysed included birthweight, gestational age,education level and age of mother, birth order,marital status and age of infant at the time ofdeath. Despite an expectation of low levels ofinequality in infant mortality, significantdifferences were found that were related to thelevel of mothers' education. In addition,infant mortality increased with birth order ofthe child in the postneonatal period and fornormal birthweight infants (even whencontrolling for other variables). Theseanomalies, we believe, have a significantsocio-economic root and not a biologicalrelationship. The inverted pattern in infantmortality for low birthweight babies foundamong Afro-American women in the U.S was alsofound for women with low levels of educationwithin the ethnically homogeneous Czechpopulation. Similar patterns were replicated atregional levels in the Czech Republic.Surprisingly, two very contrasting regions (interms of socio-economic development andfunctions) – Prague and Ceske Budejovice –were found to have the highest risk of infantdeath, characterized primarily by increasedrisk for infants in the ``normal'' or usually lowrisk categories.