W. Parker Frisbie

PARADOX FOUND (AGAIN): INFANT MORTALITY AMONG THE MEXICAN-ORIGIN POPULATION IN THE UNITED STATES*

Recent research suggests that the favorable mortality outcomes for the Mexican immigrant population in the United States may largely be attributable to selective out-migration among Mexican immigrants, resulting in artificially low recorded death rates for the Mexican-origin population. In this paper, we calculate detailed age-specific infant mortality rates by maternal race/ethnicity and nativity for two important reasons: (1) it is extremely unlikely that women of Mexican origin would migrate to Mexico with newborn babies, especially if the infants were only a few hours or a few days old; and (2) more than 50% of all infant deaths in the United States occur during the first week of life, when the chances of out-migration are very small. We use concatenated data from the U.S. linked birth and infant death cohort files from 1995 to 2000, which provides us with over 20 million births and more than 150,000 infant deaths to analyze. Our results clearly show that first-hour, first-day, and first-week mortality rates among infants born in the United States to Mexican immigrant women are about 10% lower than those experienced by infants of non-Hispanic, white U.S.-born women. It is extremely unlikely that such favorable rates are artificially caused by the out-migration of Mexican-origin women and infants, as we demonstrate with a simulation exercise. Further, infants born to U.S.-born Mexican American women exhibit rates of mortality that are statistically equal to those of non-Hispanic white women during the first weeks of life and fare considerably better than infants born to non-Hispanic black women, with whom they share similar socioeconomic profiles. These patterns are all consistent with the definition of the epidemiologic paradox as originally proposed by Markides and Coreil (1986).

Phenotype and Life Chances Among Chicanos

Data from a national Chicano survey with nearly 1000 respondents were examined to test the hypothesis that because of internal (intragroup) and external (intergroup) discrimination, both past and present, Mexican Americans with a European physical appearance will have more enhanced life chances as measured by higher socioeconomic status than Mexican Americans with an indigenous Native American physical appearance. Two variables, skin color and physical features, were combined into a composite variable of observed phenotype. When observed phenotype was correlated with indicators of socioeconomic status, the hypothesis was largely confirmed.

The increasing racial disparity in infant mortality: Respiratory distress syndrome and other causes

Although substantial declines in infant mortality rates have occurred across racial/ethnic groups, there has been a marked increase in relative black-white disparity in the risk of infant death over the past two decades. The objective of our analysis was to gain insight into the reasons for this growing inequality on the basis of data from linked cohort files for 1989–1990 and 1995–1998. We found a nationwide reversal from a survival advantage to a survival disadvantage for blacks with respect to respiratory distress syndrome over this period. The results are consistent with the view that the potential for a widening of the relative racial gap in infant mortality is high when innovations in health care occur in a continuing context of social inequality. As expected, the results for other causes of infant mortality, although similar, are less striking. Models of absolute change demonstrate that among low-weight births, absolute declines in mortality were greater for white infants than for black infants.

Alternate scenario planning

Abstract Although a number of organizations are attempting to add flexibility to their planning efforts by using Alternate Scenario Planning techniques, formal methodologies for preparing appropriate scenario sets are only now being developed. One 12-step scenario set generation technique is described in this article, and a particular application of the technique by a government-industry-university team is discussed.

Hispanic Pregnancy Outcomes: Differentials Over Time and Current Risk Factor Effects

In light of major changes over the past decade or two in the structure of infant mortality in the United States, the primary objectives of this article are to document recent variation in pregnancy outcomes in specific Hispanic populations compared with non-Hispanic Whites and to estimate the contemporaneous association of ethnicity with risk of preterm birth, low birth weight, and infant mortality. The primary data employed are the 1995–1997 NCHS Linked Birth/Infant Death Files. Changes over time are examined through comparisons with the 1989–1991 counterpart files. Logistic regression models provide estimates of ethnic disparities in birth weight, gestational age, and infant mortality. Every ethnic population followed the national pattern of increasing rates of adverse birth outcomes coupled with declining rates of infant mortality. Net of the effects of a wide range of risk factors, every Hispanic group was at greater risk of short gestation and low-weight births, but at lower risk of infant death. The findings are consistent with the view that Hispanics, as well as the White, non-Hispanic majority, have benefited from advances in neonatal health services and technology at the time of delivery and postpartum. The epidemiologic paradox appears to be applicable to some, but not all, Hispanic groups.

Demographic models of birth outcomes and infant mortality: An alternative measurement approach

Most demographic studies use 2,500 grams of birth weight and 37 weeks of gestation as cutpoints for evaluating the effects of adverse birth outcomes on infant mortality. We propose an alternative strategy, which relies on continuous measures of birth outcomes, identifies an optimal combination of birth weight and gestational age for infant survival, and estimates the effects of adverse birth outcomes in terms of their departure from this “optimal point.” We illustrate the advantages of this approach by estimating a logistic model using data from the 1989–1991 NCHS linked birth/infant death files. Finally, we discuss future applications and methodological issues to be resolved in subsequent research.

Low birth weight in Mexico: New evidence from a multi-site postpartum hospital survey

OBJECTIVE To identify factors related to cases of low birth weight among a sample of Mexican women. MATERIAL AND METHODS The present analysis utilizes data from a post partum survey of 565 women implemented in eight different social security hospitals in western Mexico during 2001. Women giving birth to low weight infants (2.5 kgs) were oversampled and make up half of the sample. RESULTS A series of logistic regression equations are presented that estimate the risk of low birth weight. Study findings indicate that, although behavioral factors appear to be highly significant in predicting the odds of low birth weight, socioeconomic and sociodemographic factors were found to be important in determining utilization of prenatal care. CONCLUSIONS The key role of behavioral characteristics in determining low birth weight risk and the role of socioeconomic and sociodemographic factors in determining prenatal care usage highlights the need to improve prenatal care utilization by disadvantaged populations.

Human Ecology, Sociology, and Demography

In 1934, R. D. McKenzie published an essay entitled “The Field and Problems of Demography, Human Geography, and Human Ecology” in the book, The Fields and Methods of Sociology, edited by L. L. Bernard. In his essay, McKenzie endeavored to show that, for purposes of scientific study, the human community could be viewed as demographic, geographic, or ecological, depending on the orientation and goals of the investigation. If concern was with the human community as a population aggregate, the community would be delineated demographically. If the relation between the population and its physical habitat was the focus of analysis, the community would be defined geographically. If studied as a symbiotic unity, the community would be described ecologically. Although McKenzie’s goal was to distinguish among these three different ways of studying the human community, our purpose here is to outline in a general manner the ecological orientation to the human community and then to show the sociological significance of the ecological orientation for the study of the demographic process of migration (see Namboodiri 1988 and 1994 for other, although not dissimilar, treatments).

Intra-Ethnic Diversity in Hispanic Child Mortality, 1890–1910*

Using a representative sample of the Hispanic population of the United States based on the manuscripts of the 1910 census, we estimate childhood mortality for the period from approximately 1890 to 1910. We find high child mortality in the Hispanic population, higher than for non-Hispanic whites but not significantly different than among nonwhite non-Hispanics (mostly African Americans). Hispanic rural farm populations in California, Texas, and Arizona experienced high mortality, but not as high as other Hispanic populations. Child mortality was very high among Hispanic residents of New Mexico and those in Florida outside Tampa; it was especially low in the Hispanic population in Tampa.

A new look at the Hispanic population of the United States in 1910.

With regard to the US Hispanic population in 1910 two maps indicate the location of Hispanic oversample counties both nationwide and in California Arizona New Mexico Texas and Kansas. The following tables are presented: the estimated size of the Hispanic population in 1910; initial sample counties for 1910 Hispanic oversample; additional sample counties for 1910 Hispanic oversample; sampling fraction and sample weights for Hispanics in the 1910 combined public use samples; computation of sample fraction and weight for Luna County New Mexico; Hispanics in the US as shown in various sources; Hispanic population in sample states; Hispanic population size in all states in 1910; oversample versus original public use sample; sex age structure literacy of men and women aged 20 years and older literacy by generation literacy by generation by state and school attendance of children age 5-18 years in the Hispanic population; percent of Hispanic population aged 20 and older which speaks English; major occupation groups among Hispanic men and women aged 15 years and older; cell sizes for state-level occupation data; family size of Hispanics and non-Hispanics; average number of own children less than age 5 years by generation; and the average number of children ever born by marriage duration together with the ratio of dead children to children ever born.