Relationships between selected socioeconomic characteristics of counties and infant mortality rates are examined. There are two research objectives: to determine the extent to which low family income, low education, sound housing, and the percentage of blacks “directly” and “jointly” relate to neonatal and postneonatal mortality rates; and to determine the degree to which a zero-order correlation between a given socioeconomic measure and general infant mortality is transmitted by neonatal and postneonatal mortality rates, respectively. Data corresponding to 2237 counties in the United States are analyzed by path analysis. Results show that the percentage of blacks and low education are two variables which have appreciable direct effects on both components of infant mortality. These two factors are also responsible in large measure for gross associations between low family income, sound housing, and rates of infant loss. On the basis of this study it is estimated that approximately two-thirds of the zero-order correlation between a given county measure of socioeconomic status and infant mortality occurs through the postneonatal component. Implications of these findings are discussed.
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References
1.
National Center for Health Statistics. Infant mortality rates: Socioeconomic factors, United States. Vital Health Stat. Series 22, No. 14, U.S. Department of Health, Education, and Welfare, Public Health Service, Rockville, Md., 1972.
2.
AndersonO. W.Infant mortality and social and cultural factors: Historical trends and current patterns. In Patients, Physicians and Illness, edited by JacoE. Gartly, pp. 10–24. The Free Press, New York, 1958.
3.
ShahF. K.AbbeyH.Effects of some factors on neonatal and postneonatal mortality: Analysis by a binary variable multiple regression method. Milbank Mem. Fund Q. 49: 33–57, 1971.
4.
DonabedianA.RosenfeldL.SouthernE. M.Infant mortality and socioeconomic status in a metropolitan community. Public Health Reports80: 1083–1094, 1965.
5.
HammoudE. I.Studies in fetal and infant mortality. I. A methodological approach to the definition of perinatal mortality. Am. J. Public Health55: 1012–1023, 1965.
6.
StockwellE. G.Infant mortality and socioeconomic status: A changing relationship. Milbank Mem. Fund Q. 40: 101–111, 1962.
7.
ChaseH. C.The Relationship of Certain Biologic and Socio-Economic Factors to Fetal, Infant, and Early Childhood Mortality. I. Father's Occupation, Parental Age, and Infant's Birth Rank. New York State Department of Health, Albany, 1961.
8.
MorrisJ. H.HeadyJ. A.Social and biological factors in infant mortality. I. Objects and methods. Lancet268: 343–349, 1955.
9.
LoganW.P.D.Social class variations in mortality. Br. J. Prev. Soc. Med.8: 128–137, 1954.
10.
AltenderferM. E.CrowtherB.Relationship between infant mortality and socioeconomic factors in urban areas. Public Health Reports64: 331–339, 1949.
11.
WillieC. V.A research note on the changing association between infant mortality and socioeconomic status. Social Forces37: 221–227, 1959.
12.
StockwellE. G.Use of socioeconomic status as a demographic variable. Public Health Reports81: 961–966, 1966.
13.
DuncanO. D.Path analysis: Sociological examples. Am. J. Sociol.72: 1–16, 1966.
14.
LandK.Principles of path analysis. In Sociological Methodology 1969, edited by BorgattaE. F., pp. 3–37. Jossey-Bass, San Francisco, 1969.
15.
SiegelP. M.HodgeR. W.A causal approach to the study of measurement error. In Methodology in Social Research, edited by BlalockH. M.BlalockA. B., pp. 28–59. McGraw-Hill, New York, 1968.
16.
BlalockH. M.Causal Models in the Social Sciences. Aldine, Chicago, 1971.
17.
FinneyJ. M.Indirect effects in path analysis. Sociological Methods and Research1: 175–186, 1972.
18.
National Center for Health Statistics. A study of infant mortality from linked records, method of study and registration aspects. Vital Health Stat. Series 20, No. 7, U.S. Department of Health, Education, and Welfare, Public Health Service, Rockville, Md., 1970.
19.
National Office of Vital Statistics. Birth registration completeness in the United States and geographic areas, 1950. II. Data for local areas. Vital Statistics-Special ReportsVol. 39, No. 4, U.S. Department of Health, Education, and Welfare, Public Health Service, Washington, D.C., 1955.
20.
U.S. Bureau of the Census. County and City Data Book, 1967. U.S. Government Printing Office, Washington, D.C., 1967.
21.
HuntE. P.HuyckE. E.Mortality of white and nonwhite infants in major U.S. cities. HEW Indicators: 23–41, January 1966.
22.
HuntE. P.Infant mortality and poverty areas. Welfare in Review5: 1–12, 1967.
23.
NorrisF. D.ShipleyP. W.A closer look at race differentials in California's infant mortality, 1965–67. HSMHA Health Reports86: 810–814, 1971.
24.
SiegelP. M.On the cost of being a Negro. In The Logic of Social Hierarchies, edited by LaumannE. O.SiegelP. M.HodgeR. W., pp. 727–743. Markham, Chicago, 1970.
25.
BlumenthalS.BergnerL.NelsonF.Low birth weight of infants associated with maternal heroin use. Health Services Reports88: 416–418, 1973.
26.
ChaseH.C.Infant mortality and weight at birth: 1960 United States birth cohort. Am. J. Public Health59: 1618–1628, 1969.
27.
ErhardtC. L.JoshiG. B.NelsonF. G.KrollB. H.WeinerL.Influence of weight and gestation on perinatal and neonatal mortality by ethnic group. Am. J. Public Health54: 1841–1855, 1964.
28.
National Center for Health Statistics. Variations in birth weight. Vital Health Stat. Series 22, No. 8, U.S. Department of Health, Education, and Welfare, Public Health Service, Washington, D.C., 1968.
29.
MullerC.Income and the receipt of medical care. Am. J. Public Health55: 510–521, 1965.
30.
WhiteE. L.A graphic presentation of age and income differentials in selected aspects of morbidity, disability, and utilization of health services. Inquiry5: 18–30, 1968.
31.
PrattL.The relationship of socioeconomic status to health. Am. J. Public Health61: 281–291, 1971.
32.
ShapiroS.JacobzinerH.DensenP. M.WeinerL.Further observations on prematurity and perinatal mortality in a general population and in the population of a prepaid group practice medical care plan. Am. J. Public Health50: 1304–1317, 1960.
33.
ChaseH. C.NelsonF. G.Education of mother, medical care and condition of infant. Am. J. Public Health63: 27–40, September Supplement, 1973.
34.
AykroydW. R.Nutrition and mortality in infancy and early childhood: Past and present relationships. Am. J. Clin. Nutr.24: 480–87, 1971.
35.
WilliamsH. S.MeyerM. B.Cigarette smoking, infant birth weight, and perinatal mortality rates. Am. J. Obstet. Gynecol.116: 890–892, 1973.
36.
RushD.KassE. H.Maternal smoking: A reassessment of the association with perinatal mortality. Am. J. Epidemol.96: 183–196, 1972.
37.
ComstockG. W.ShahF. K.MeyerM. B.AbbeyH.Low birth weight and neonatal mortality rate related to maternal smoking and socioeconomic status. Am. J. Obstet. Gynecol.11: 53–59, 1971.
38.
AbernathyJ. R.GreenbergB. G.WellsH. B.FrazierT. M.Smoking as an independent variable in a multiple regression analysis upon birth weight and gestation. Am. J. Public Health56(4): 626–633, 1966.
39.
DalyC.HeadyJ. A.MorrisJ. N.The effect of mother's age and parity on social class differences in infant mortality. Lancet268: 445–448, 1955.
40.
SchlesingerE. R.MazumdarS. M.LogrilloV. M.Long-term trends in perinatal deaths among offspring of mothers with previous child losses. Am. J. Epidemiol.96: 255–262, 1972.
41.
NiswanderK. R.BerendesH.Effect of maternal cardiac disease on the infant. Clinical Obstet. Gynecol.11: 1026–1040, 1968.
42.
ShapiroS.RossL. J.LevineH. S.Relationship of selected prenatal factors to pregnancy outcome and congenital anomalies. Am. J. Public Health55: 268–282, 1965.
43.
DesmondM. M.FranklinR. R.BlattnerR. J.HillR. M.The relation of maternal disease to fetal and neonatal morbidity and mortality. Pediatr. Clin. North Am. 8: 421–440, 1961.
44.
RobinsonW. S.Ecological correlations and the behavior of individuals. Am. Sociol. Rev.15: 351–357, 1950.
45.
National Center for Health Statistics. Infant and perinatal mortality in the United States. Vital Health Stat. Series 3, No. 4, U.S. Department of Health, Education and Welfare, Public Health Service, Washington, D.C., 1965.
46.
GroveR. D.HetzelA. M.Vital Statistics Rates in the United States: 1940–1960, Table 38. U.S. Government Printing Office, Washington, D.C., 1968.
47.
CollinsJ. J.KasapH. S.HollandW. W.Environmental factors in child mortality in England and Wales. Am. J. Epidemiol.93: 10–22, 1971.
48.
BrennerM. H.Fetal, infant, and maternal mortality during periods of economic instability. Int. J. Health Serv. 3: 145–159, 1973.
49.
ShapiroS.SchlesingerE. R.NesbittR.E.L.Jr.Infant, Perinatal, Maternal and Childhood Mortality in the United States. Harvard University Press, Cambridge, 1968.
