Jerry W. Wicks

Patterns and variations in the relationship between infant mortality and socioeconomic status

This study utilizes an ecological approach based on census tracts of residence to examine the relationship between infant mortality and socioeconomic status in metropolitan Ohio, US, at 2 two points in time (1959-1961 and 1969-1971). The data presented clearly indicate that the infant mortality rate continues to exhibit a pronounced inverse association with a wide variety of socioeconomic variables. Although there were some notable exceptions and variations from the general patterns, a basic inverse relationship was characteristic of both neonatal and postneonatal components of infant mortality, for both males and females, and for both major exogenous and endogenous causes of death. Of all the variables examined, the 1 factor that emerged as the strongest and most consistent determinant of census tract variations in infant mortality was the proportion of low income families. Thus, the overriding conclusion suggested by this study is that in spite of such things as continued advances in medicine and public health, the expansion of social programs during the 1960s, and the recent resumption of a downward trend in the infant mortality rate, there has been little if any progress in achieving more equitable life chances for the economically deprived segments of our population.

Temporal variations in the relationship between infant mortality and economic status.

Data from a metropolitan aggregate comprising three Ohio cities for the years 1959–61, 1969–71 and 1979–81 reveal some noteworthy variations over time in the nature and magnitude of the traditional inverse association between economic status and infant mortality. This brief paper describes these variations and offers an explanation for the observed temporal changes that relates the influence of medical and infant health care advances to the prevailing overall economic situation.

The age‐cause proxy relationship in infant mortality

Data presented in this brief note show that one of the consequences of recent gains in the control of neonatal mortality has been an increase in the frequency of endogenous causes of death in the postneonatal period. Several conclusions are readily apparent from the data presented here. 1st, with respect to total infant mortality, the vast majority of the deaths under 1 year of age today are caused by the endogenous conditions that are most closely associated with the physiological processes of gestation and births. 2nd, both the exogenous and endogenous cause-specific death rates are inversely associated with family income status. The strength of the relationship, as measured by the difference between the death rates of the highest and lowest income areas, is much greater for the environmentally related exogenous causes. Further, there is an obvious tendency for the exogenous causes to account for an increasing proportion of total deaths as income status decreases. While these data support research findings that challenge the validity of the traditional age/cause of death proxy relationship in infancy, they suggest that recommendations for enhancing the neonatal/endogenous relationship by shortening the neonatal period may be premature.

Sterilization anxiety and fertility control in the later years of childbearing.

By 1982 sterilization had become the most prevalent form of contraception among married couples in the US. There are now over 15 million US men and women who have chosen sterilization as their form of contraception and the number increasing by 1 million every year. Because this method of contraception is irreversible the present research was directed at examining the attitudes of married couples regarding sterilization in their later years of childbearing. The study distinguishes between 3 types of couples: 1) those that are sterilized; 2) those planning a sterilization; and 3) those opposed to sterilization. Data was collected from a sample of married couples in 1978 and again in 1985-86. The 1st random sample consisted of 610 white couples in Toledo who were within their first 6 years of marriage. The data was collected through a self-administered questionnaire. Using the same procedures the 2nd time data was collected again in 1985-86 from 544 of the couples surveyed in 1978 yielding a return rate of 89.2% from 610 initial couples. The final sample comprised 338 couples where one or both spouses reported not wanting additional children. Findings from the study indicate that in spite of the dramatic increase in contraceptive sterilization this decision may be accompanied by high levels of anxiety and stress. The perceived linkage between sexual identity and sexual performance constitutes one of the major forms of ambivalence regarding sterilization. There are gender differences between the loss of fecundity. Men worry more about the pain of surgery and the effects of sterilization on their sexual functioning (impotence). (Authors modified).

Trends in the Relationship between Infant Mortality and Socioeconomic Status

Abstract This paper reports some of the results of an ecological analysis of the relationship between infant mortality and economic status in metropolitan Ohio at three points in time (1959–1961, 1969–1971 and 1979–1981). The data presented clearly reveal the adverse mortality consequences of alow economic status. In spite of some remarkable declines in the infant death rate since 1960, most notably in neonatal mortality, the inverse socioeconomic differential in 1980 is as wide as it ever was, and it characterizes both whites and nonwhites and both the neonatal and postneonatal components of infant mortality. Moreover, in sharp contrast to the situation a generation ago, the neonatal death rate has emerged as a major contributor to the overall relationship between socioeconomic status and infant mortality. It is suggested that this situation reflects the failure of recent advances in maternal and infant care programs to reach those lower status members of the society that are most in need of them.

Public policy and the socioeconomic mortality differential in infancy

This paper discusses some of the findings and policy implications of a recently completed study of socioeconomic differences in infant mortality in eight metropolitan areas of Ohio at three points in time. The study revealed that, in spite of a considerable decline in the overall rate of infant mortality since 1960, the inverse socioeconomic differential remains as wide as ever. This clearly suggests that, although maternal and child health has improved overall, the lower economic groups in our society still do not have equal access either to health care or to other amenities essential to the maintenance of good health. Moreover, consideration of recent and current policy proposals with respect to welfare programs in general, and maternal and child health care programs in particular, leads to the conclusion that this situation is not likely to change in the near future. Finally, some policy recommendations for enhancing the health status of low-income families are offered.

Sex-role attitudes and the anticipated timing of the initial stages of family formation among Catholic university students.

Increasingly fertility is being viewed as the culmination of a highly complex and dynamic process. The extent to which sex role attitudes influence this process in particular the events comprising the initial stages of family formation is tested using a sample of 194 white nevermarried Catholic university students. Findings indicate that among both male and female respondants certain dimensions of sex role attitudes directly and indirectly influence initial family formation plans and that the more traditional and respondant -- with respect to the relative economic role of husband and wife and the importance of the family in providing a secure relationship -- the earlier marriage and the birth of the 1st child are planned.(AUTHOR ABSTRACT)