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Why did postperinatal mortality rates fall in the 1970s?
Journal of Epidemiology and Community Health
|September 1, 1986
Summary
Child mortality rates declined in two phases, but social and medical factors alone don't explain the 1960s plateau. A "generation effect" suggests biological influences impact child survival, necessitating a review of preventable deaths.
Area of Science:
- Public Health
- Pediatrics
- Demography
Background:
- Postperinatal mortality rates exhibited two distinct decline phases post-1947, traditionally attributed to societal advancements and medical innovations.
- The decline's stagnation during the 1960s cannot be fully explained by these conventional factors, suggesting underlying biological influences.
- A 'generation effect' is hypothesized, linked to evolving demographic structures resulting from parental generation's childhood social and biological changes.
Purpose of the Study:
- To investigate the unexplained plateau in postperinatal mortality decline during the 1960s.
- To identify potential biological factors, specifically a 'generation effect,' influencing child mortality trends.
- To categorize postperinatal deaths and assess the prevalence of preventable mortality.
Main Methods:
- Analysis of national and selected urban postperinatal death data.
- Classification of deaths into 'probably inevitable' and 'possibly preventable' categories.
- Examination of trends in relation to social, medical, and hypothesized biological factors.
Main Results:
- The study identified a 'generation effect' impacting child mortality rates, stemming from intergenerational social and biological changes.
- A significant proportion of postperinatal deaths were categorized as 'possibly preventable,' indicating room for intervention.
- The persistence of preventable deaths highlights a critical area for public health focus.
Conclusions:
- Conventional explanations are insufficient to account for historical trends in postperinatal mortality.
- Biological and generational factors play a significant role in child mortality dynamics.
- Reducing 'possibly preventable' deaths requires strategic reconsideration and reallocation of community child health resources.
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