Patterns of infant mortality from Armenian parish records: a study from 10 countries of the diaspora, 1737-1982
Armenian, H.K.; McCarthy, J.F.; Balbanian, S.G.
International Journal of Epidemiology 22(3): 457-462
1993
ISSN/ISBN: 0300-5771 PMID: 8359961 DOI: 10.1093/ije/22.3.457Document Number: 327048
The use of parish records of the Armenian infant mortality rate (IMR) illustrates the trends of IMR over time and among Armenian population in different countries, and indicates the overall health of the population at different stages of development. The data from parish records collected by the Armenian Genealogical Society is reasonably valid as a whole, but suffers from misclassification bias reporting in the cause of death. Cause of death was reported in only 60% of cases. Coding of specific causes was based on List B of the List of 50 Causes from the ICD, 8th Revision. Heaping may occur at age 1, but mortality both above and below age 1 was rounded and may minimize this bias. Bias is reporting neonatal deaths is possible, but 78.4% of deaths were linked to baptismal records. Uniformity of recording systems were established by the Armenian church after 1863. IMR data span a period of 245 years (1737-1982) and includes information from 10 countries having long standing Armenian communities: Singapore, Burma, Bangladesh, Indonesia, India, Egypt, Palestine, Cyprus, Greece, and Belgrade, Yugoslavia. Baptismal records were used to calculate births for the denominator in the IMR. Tabulations were made by the church, which showed variations in the proportion of successful matches of births and deaths. Data were available by age, sex, and geographical distribution and varied through time and seasons. In the analysis of time trends, it was revealed that IMR declined continuously but varied for all countries. In India and the Far East, IMR was consistently lower that the IMR from the Middle East parishes. Greece and Cyprus also had somewhat low IMR. The large settlements of Armenians had the highest IMR; these large communities also were communities with low socioeconomic status. Between 1910 and 1919, IMR from Palestine parishes increased; this may have been due to the refugees fleeting persecution and genocide in Armenia and those deported from Turkey. Economic and health conditions among refugees were known to be poor. Neonatal deaths were higher in countries with low IMR. Peak deaths occurred during the months of May and August. Gastroenteritis was a primary cause of death. The most important causes of death were due to diarrhea and respiratory infections. Neonatal deaths were primarily due to congenital anomalies. Many of the death clusters occurred during peak epidemics.