Social inequalities and health. Socioeconomic level and infant mortality in Chile in 1985-1995
Hollstein, R.D.; Vega, J.; Carvajal, Y.
Revista Medica de Chile 126(3): 333-340
1998
ISSN/ISBN: 0034-9887 PMID: 9674305 Document Number: 489733
Birth and death statistics from Chile¿s National Institute of Statistics were used to determine the influence of socioeconomic status as measured through maternal educational level on infant mortality from 1990-95 and to assess trends since 1985. The rates of infant, neonatal, and postneonatal mortality were calculated for 6 educational groups for the mother and father: 0, 1-3, 4-6,7-9, 10-12, and 13 or more years. The deaths were classified by cause according to the International Classification of Diseases and to Taucher¿s classification into avoidable, difficult to avoid, poorly defined, and other causes. A clear association was observed in levels of infant mortality according to maternal education. Infant mortality rates ranged from 38.2/1000 live births for children of illiterate mothers to 7.8/1000 for children of mothers with higher education. A child of an illiterate mother had a risk of death in the first year 4.9 times higher than the child of a mother with higher education. The same trend was observed for neonatal mortality and for paternal education. The mortality gradient by maternal education was maintained for all causes of death and both classifications studied. Diseases of the respiratory system had a relative risk (RR) of 14.3 and a population attributable risk (PAR) of 73%, trauma had an RR of 11.3 and PAR of 69%, and infectious diseases had an RR of 10.8 and PAR of 62%. Infant mortality rates declined between 1985-95 in all maternal educational groups, but the inequalities remained.