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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1993 Aug;47(4):260–264. doi: 10.1136/jech.47.4.260

Influence of socioeconomic and health care development on infant and perinatal mortality in Spain 1975-86.

P Lardelli 1, J I Blanco 1, M Delgado-Rodríguez 1, A Bueno 1, J de Dios Luna 1, R Gálvez 1
PMCID: PMC1059789  PMID: 8228758

Abstract

STUDY OBJECTIVE--This study aimed to analyse the influence of social, economic, and health development on infant and perinatal mortality in Spain between 1975 and 1986, and to identify possible changes in these relationships over time. DESIGN--Study of the association between mortality and a range of variables. SETTING--50 Spanish provinces. MEASUREMENTS AND MAIN RESULTS--Mean infant and perinatal mortality were estimated for two periods--1975-8 and 1983-6. Social, economic, and health care indicators were collected as independent variables for these two periods. The rates of variation between periods were estimated for each variable. Multiple linear regression models were used to define the association between infant and perinatal mortality and their respective rate of variation with the former indicators. Mean familial income was the main predictive factor for infant and perinatal mortality in the first period but in the second period health care indicators were more relevant. CONCLUSIONS--The reduction in Spanish infant and perinatal mortality over the period can be attributed mainly to the improvement in prenatal and neonatal health care in Spain in recent years, while economic factors seem less important.

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Selected References

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  1. Bloom B. S. Changing infant mortality: the need to spend more while getting less. Pediatrics. 1984 Jun;73(6):862–866. [PubMed] [Google Scholar]
  2. Bolumar F., Garrucho G., Megía M. J., Muñoz Martińez A., Valverde A., Pérez Bermúdez F., García Jiménez D., Cortés Majo M., Ruiz Peláez M. L., Soriano Parés A. La mortalidad en España, I. La mortalidad infantil en España 1900-1976. Valoración regional. Rev Sanid Hig Publica (Madr) 1981 Nov-Dec;55(11-12):1205–1219. [PubMed] [Google Scholar]
  3. Bradshaw J., Edwards H., Lawton D., Staden F., Weale J., Weekes A. Area variations in infant mortality 1975-7. J Epidemiol Community Health. 1982 Mar;36(1):11–16. doi: 10.1136/jech.36.1.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Buck C., Bull S. Preventable causes of death versus infant mortality as an indicator of the quality of health services. Int J Health Serv. 1986;16(4):553–563. doi: 10.2190/QWWN-518N-5VFC-6272. [DOI] [PubMed] [Google Scholar]
  5. David R. J., Siegel E. Decline in neonatal mortality, 1968 to 1977: better babies or better care? Pediatrics. 1983 Apr;71(4):531–540. [PubMed] [Google Scholar]
  6. Dujardin B., Vandenbussche P., Buekens P., Wollast E. Evolution récente de la mortalité infantile. Le cas de la Belgique. Arch Fr Pediatr. 1986 Apr;43(4):275–278. [PubMed] [Google Scholar]
  7. Ericson A., Eriksson M., Källén B., Zetterström R. Socio-economic variables and pregnancy outcome. 2. Infant and child survival. Acta Paediatr Scand. 1990 Nov;79(11):1009–1016. doi: 10.1111/j.1651-2227.1990.tb11376.x. [DOI] [PubMed] [Google Scholar]
  8. Ericson A., Eriksson M., Westerholm P., Zetterström R. Pregnancy outcome and social indicators in Sweden. Acta Paediatr Scand. 1984 Jan;73(1):69–74. doi: 10.1111/j.1651-2227.1984.tb09900.x. [DOI] [PubMed] [Google Scholar]
  9. García Gil C., Cortés M., Durán C. Mortalidad perinatal en España. La necesidad del enfoque epidemiológico. Rev Sanid Hig Publica (Madr) 1989 Jul-Aug;63(7-8):19–30. [PubMed] [Google Scholar]
  10. González Pérez G., Herrera León L. Desarrollo social y mortalidad infantil, 1977-1986, Cuba. Un analisis regional. Rev Saude Publica. 1990 Jun;24(3):186–195. doi: 10.1590/s0034-89101990000300004. [DOI] [PubMed] [Google Scholar]
  11. Gould J. B., Davey B., LeRoy S. Socioeconomic differentials and neonatal mortality: racial comparison of California singletons. Pediatrics. 1989 Feb;83(2):181–186. [PubMed] [Google Scholar]
  12. Hansen-Koenig D., Manciaux M., Deschamps J. P. La mortalité péri-natale au Grand-Duché de Luxembourg. Evolution de 1969 à 1979. Rev Epidemiol Sante Publique. 1983;31(2):129–142. [PubMed] [Google Scholar]
  13. Knox E. G., Marshall T., Kane S., Green A., Mallett R. Social and health care determinants of area variations in perinatal mortality. Community Med. 1980 Nov;2(4):282–290. [PubMed] [Google Scholar]
  14. Kunitz S. J., Simić S., Odoroff C. L. Infant mortality and economic instability in Yugoslavia. Soc Sci Med. 1987;24(11):953–960. doi: 10.1016/0277-9536(87)90288-7. [DOI] [PubMed] [Google Scholar]
  15. Lardelli P., Masa J., Maderuelo A., Delgado M., Gálvez R. Infant, neonatal, postneonatal and perinatal mortality in Spain, 1975-1984. Interregional and interannual differences. Soc Sci Med. 1991;33(5):613–620. doi: 10.1016/0277-9536(91)90219-3. [DOI] [PubMed] [Google Scholar]
  16. Nersesian W. S. Infant mortality in socially vulnerable populations. Annu Rev Public Health. 1988;9:361–377. doi: 10.1146/annurev.pu.09.050188.002045. [DOI] [PubMed] [Google Scholar]
  17. Paneth N., Wallenstein S., Kiely J. L., Susser M. Social class indicators and mortality in low birth weight infants. Am J Epidemiol. 1982 Aug;116(2):364–375. doi: 10.1093/oxfordjournals.aje.a113420. [DOI] [PubMed] [Google Scholar]
  18. Pendleton B. F., Yang S. O. Socioeconomic and health effects on mortality declines in developing countries. Soc Sci Med. 1985;20(5):453–460. doi: 10.1016/0277-9536(85)90360-0. [DOI] [PubMed] [Google Scholar]
  19. Piekkala P., Erkkola R., Kero P., Tenovuo A., Sillanpä M. Declining perinatal mortality in a region of Finland, 1968-82. Am J Public Health. 1985 Feb;75(2):156–160. doi: 10.2105/ajph.75.2.156. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Rosero-Bixby L. Costa Rica saves infants' lives. World Health Forum. 1988;9(3):439–443. [PubMed] [Google Scholar]
  21. Salleras L., Sentis J., Canela J., Garcia A. Facteurs sociaux et d'assistance sanitaire et mortalité périnatale en Espagne--étude écologique. Rev Epidemiol Sante Publique. 1988;36(1):30–35. [PubMed] [Google Scholar]
  22. Stembera Z., Kravka A., Mandys F. Countrywide analysis of perinatal outcome. J Perinat Med. 1988;16(4):391–396. doi: 10.1515/jpme.1988.16.4.391. [DOI] [PubMed] [Google Scholar]
  23. Stockwell E. G., Swanson D. A., Wicks J. W. Economic status differences in infant mortality by cause of death. Public Health Rep. 1988 Mar-Apr;103(2):135–142. [PMC free article] [PubMed] [Google Scholar]
  24. Tenovuo A., Kero P., Piekkala P., Sillanpä M., Erkkola R. Advances in perinatal care and declining regional neonatal mortality in Finland, 1968-82. Acta Paediatr Scand. 1986 May;75(3):362–369. doi: 10.1111/j.1651-2227.1986.tb10216.x. [DOI] [PubMed] [Google Scholar]
  25. West R. R. Perinatal and infant mortality in Wales: inter-district variations and associations with socio-environmental characteristics. Int J Epidemiol. 1988 Jun;17(2):392–396. doi: 10.1093/ije/17.2.392. [DOI] [PubMed] [Google Scholar]
  26. Williams R. L., Chen P. M. Identifying the sources of the recent decline in perinatal mortality rates in California. N Engl J Med. 1982 Jan 28;306(4):207–214. doi: 10.1056/NEJM198201283060404. [DOI] [PubMed] [Google Scholar]
  27. Woolhandler S., Himmelstein D. U. Militarism and mortality. An international analysis of arms spending and infant death rates. Lancet. 1985 Jun 15;1(8442):1375–1378. doi: 10.1016/s0140-6736(85)91795-7. [DOI] [PubMed] [Google Scholar]
  28. Zurriaga Llorens O., Alfonso Sánchez J. L., Sanchis Noguera B., Prado Del Baño M. J., Cortina Greus P. Algunos factores determinantes de la mortalidad infantil en España. Salud Publica Mex. 1990 Nov-Dec;32(6):665–672. [PubMed] [Google Scholar]

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