Your search found 19 Results

  1. 1
    Peer Reviewed

    National estimates for maternal mortality: an analysis based on the WHO systematic review of maternal mortality and morbidity.

    Betrán AP; Wojdyla D; Posner SF; Gülmezoglu AM

    BMC Public Health. 2005 Dec 12; 5:131.

    Despite the worldwide commitment to improving maternal health, measuring, monitoring and comparing maternal mortality estimates remain a challenge. Due to lack of data, international agencies have to rely on mathematical models to assess its global burden. In order to assist in mapping the burden of reproductive ill-health, we conducted a systematic review of incidence/prevalence of maternal mortality and morbidity. We followed the standard methodology for systematic reviews. This manuscript presents nationally representative estimates of maternal mortality derived from the systematic review. Using regression models, relationships between study-specific and country-specific variables with the maternal mortality estimates are explored in order to assist further modelling to predict maternal mortality. Maternal mortality estimates included 141 countries and represent 78.1% of the live births worldwide. As expected, large variability between countries, and within regions and subregions, is identified. Analysis of variability according to study characteristics did not yield useful results given the high correlation with each other, with development status and region. A regression model including selected country-specific variables was able to explain 90% of the variability of the maternal mortality estimates. Among all country-specific variables selected for the analysis, three had the strongest relationships with maternal mortality: proportion of deliveries assisted by a skilled birth attendant, infant mortality rate and health expenditure per capita. With the exception of developed countries, variability of national maternal mortality estimates is large even within subregions. It seems more appropriate to study such variation through differentials in other national and subnational characteristics. Other than region, study of country-specific variables suggests infant mortality rate, skilled birth attendant at delivery and health expenditure per capita are key variables to predict maternal mortality at national level. (author's)
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  2. 2

    The world population plan of action and the Mexico draft recommendations: analytical comparisons and index.

    United Nations. Department of Internation Economic and Social Affairs. Population Division

    [Unpublished] 1984 Jul 23. 136 p. (ESA/P/WP/85)

    This document, prepared primarily for use within the UN Secretariat, systematically compares the recommendtions of the World Population Plan of Action (WPPA) and the Mexico Draft recommendations for the implementation of the WPPA. There are 109 recommendations in the WPPA, and 85 in the Mexico Draft; they are compared using a 2-column format. An index provides cross referencing. Topics covered include the family and the staus of women, population characteristics (addressing, in particular, the implications of the increasing proportion of young persons in populations of developing countries), and the links between morbidity and mortality and family planning. For example, the WPPA notes that "mortality reduction may be a prerequisite to a decline in fertility." In light of this, the Mexico Draft recommends that governments take immediate action to increase infant survival by expanding the use of oral rehydration therapy, immunization, and the promotion of breast feeding. In addition, nutrient supplements and appropriate day-care facilities should be provided for nursing mothers in the labor force. Other areas addressed include the need to promote the development of management in all fields related to population. This need can be met with a worldwide system of institutions designed totrain personnel. Present educational institutions should expand their curricula to include the study of population dynamics and policy. Developing countries should be provided with technical equipment and financial support to improve library facilities, computer services, data-gathring, and analysis. While international cooperation is considered crucial to the implementation of the WPPA, national governments are urged to make the attainment of self-reliance in the management of their population programs a high priorit. In recognition of the diversity of national goals, no recommendations are made regarding a world family-size norm.
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  3. 3

    [Infant girls in danger of dying] Pigeborn i livsfare.

    Milwertz J

    SYGEPLEJERSKEN. 1992 Mar 11; 92(11):26.

    A new method of predicting the gender of the unborn child has made it a practice in Bombay to abort about 40,000 female fetuses per year. In only one hospital 8000 such induced abortions have been recorded. Sex discrimination in developed countries manifests itself in the work place, wages, and access to work, but in India and other countries such discrimination is often deadly. In some Asian countries there are fewer women than men; at least 60 million women are missing from statistics. The Southeast Asian Association for Regional Cooperation (SAARC) declared the 1990s the decade of the infant girls, with educational efforts geared to their survival, protection, and development. 70 state and government leaders took part in the world meeting on children in 1990. UNICEF supports the endeavor to draw attention to the plight of women. The reason for many millions of women missing in Asia is that 5-6% more boys than girls are born. Under normal circumstances mortality is higher among boys than girls in all age groups. In Denmark there are 105 women for every 100 men, but according to the 1991 Indian census there were 92.9 women for every 100 men, a decrease from 93.4 in 1981. In Afghanistan, Bangladesh, Bhutan, China, Nepal, and Pakistan the gender ratio is similar. Both mothers and fathers are responsible, because of tradition, when it comes to choosing a girl or a boy. A large number of girls die of undernutrition and untreated diseases. They are forced to work in the household, in agriculture, or in industry twice as many hours than boys. Thus, they do not have time to go to school. The bordellos of Bangkok, Bombay, Calcutta, and Manila have a constant supply of young women for tourists from rich countries. In most cases they are forced into prostitution because of the poverty of parents. In the Indian state of Karnataka 8-10 year old daughters are rendered as temple servants who end up as prostitutes after ritual deflowering at puberty. Social engagement, political will, and education could give Asia's infant girls a chance to be on equal footing with their brothers.
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  4. 4

    Using 30-cluster survey to assess neonatal and perinatal mortality [letter]

    Aras R; Velhal G; Pai N; Naik V

    WORLD HEALTH FORUM. 1991; 12(4):449-50.

    Staff at the Shivajinagar Urban Health Centre in Deonar (population 250,000) near Bombay, India conducted a cluster survey in 30 sectors of the slum using the WHO methodology for evaluating immunization coverage to measure neonatal and perinatal mortality among births that occurred between November 1986-April 1988. They gathered information on 54 births for the case group and 9 controls from each cluster. 1610 live births and 19 stillbirths occurred in the study period. There were 27.6 perinatal deaths for every 1000 total births (standard error=1.108). Neonatal deaths equalled 28.6/1000 live births (standard error-1.126). Confidence intervals for perinatal mortality rate and neonatal mortality rate were 25.39-29.82 and 26.35-30.85 and significant (p<.05). 26.4% of births occurred at home. Untrained women attended 84.6% of these deliveries. The remaining births occurred at the municipal general hospital or at a municipal maternity home. 60% of the fetal deaths were females. 77% of the 26 early neonatal deaths were males, but the male female ratio of deaths after 7 days was the same. The leading causes of neonatal mortality were prematurity and low birth weight. Other causes included congenital malformations and neonatal tetanus. Obstructed labor resulted in fetal death in 40% of stillbirths. The researchers at the Shivajinagar Urban Health Centre in Deonar, India concluded that the 30-cluster survey technique was effective in measuring perinatal and neonatal mortality in a community with >50,000 people in a developing country.
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  5. 5

    A new analysis of United Nations mortality statistics.

    Reading VM; Weale RA


    Demographic data published by the UN in 1987 are analyzed in terms of the Gompertz function. Projections for maximum lifespans are obtained, with the data broadly divisible into 3 clusters. These are attributable not only to the influence of high infant mortality, but suggest constitutional and/or environmental variations among members of the clusters. The difference between lifespan and life expectancy is estimated analytically. A comparison with earlier analysis supports the view that there are important differences between the life expectancies of the sexes.
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  6. 6

    [Data and analysis methodology] Donnees et methodes d'analyse.

    United Nations. Economic Commission for Africa. Secretariat

    In: Infant and childhood mortality and socio-economic factors in Africa. (Analysis of national World Fertility Survey data) / Mortalite infantile et juvenile et facteurs socio-economiques en Afrique. (Analyse des donnees nationales de l'Enquete Mondiale sur la Fecondite), [compiled by] United Nations. Economic Commission for Africa [ECA]. Addis Ababa, Ethiopia, United Nations, ECA, 1987. 7-26. (RAF/84/P07)

    Technical problems and methods associated with the analysis of differential child mortality data for a conference of representatives from 8 African countries, sponsored by the UN Economic Commission for Africa and the International Statistical Institute are described. The data being interpreted were from the World Fertility Surveys, conducted between 1977 and 1981, including complete birth histories of women up to 50 years of age. A core questionnaire contained 7 sections on woman's background, maternity history, contraceptive knowledge and marriage history, fertility regulation, work history and husband's background. Mortality was measured by Brass methods and the cohort approach with analysis of determining factors. No adjustment was made for omission of births and of dead children: since underreporting is more likely to occur in the past, current mortality estimates can be considered fairly accurate. Methods of correcting for misreporting are described. The extent of potential bias due to lack of data on children whose mothers were deceased at the time of survey is unknown. Another source of bias is truncation due to loss of data on older children born to older women. Generally the quality of the World Fertility Survey mortality data is reasonably good, compared to other studies.
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  7. 7

    [Introduction] Introduction.

    United Nations. Economic Commission for Africa. Secretariat

    In: Infant and childhood mortality and socio-economic factors in Africa. (Analysis of national World Fertility Survey data) / Mortalite infantile et juvenile et facteurs socio-economiques en Afrique. (Analyse des donnees nationales de l'Enquete Mondiale sur la Fecondite), [compiled by] United Nations. Economic Commission for Africa [ECA]. Addis Ababa, Ethiopia, United Nations, ECA, 1987. 1-4. (RAF/84/P07)

    After completion of the World Fertility Survey, the UN Economic Commission for Africa (ECA) held a workshop for representatives from 15 African countries to utilize the SPSS program for demographic data analysis to prepare reports on their own countries' infant and child mortality trends. The introduction to the report on the workshop highlights findings which include infant mortality rates around 90/1000 births in Kenya, Nigeria and Cameroon, and 100 or more in Benin, Ivory Coast, and Senegal. Mortality was less than 80 in Sudan and Mauritania, possibly reflecting serious deficiencies in the data. Childhood mortality was over 100/1000 in Benin, and lowest in Kenya and Ivory Coast, around 70. There were clear indications of decline in mortality in the last 20 years in Cameroon, Ivory Coast, Kenya, Nigeria and Senegal. Among the variables examined for their influence on mortality, maternal education and birth intervals clearly were the strongest, suggesting directions for policy.
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  8. 8

    Inequalities in health-facts and implications.

    Hansluwka H

    In: Mortality and health issues in Asia and the Pacific: report of a seminar held at Beijing in collaboration with the Institute of Population Research, People's University of China from 22 to 27 October 1986. New York, New York, United Nations, 1987. 151-69. (Asian Population Studies Series No. 78.; ST/ESCAP/485.)

    The question arising out of this preliminary review of inequities in health in the Economic and Social Commission for Asia and the Pacific (ESCAP) region is whether the broad outlines and recommendations of the Alma Ata Conference 1) are based on a scientifically valid evaluation of available information and 2) constitute a solid basis for leading the region into the 21st century. One must credit the World Health Organization (WHO) for having initiated a global process towards the design and evaluation of health policies and programs on a scientific and rational basis. Formidable problems of collection, analysis, and interpretation of information await solution. If critique is to be levelled at WHO and national health administrations, it is not the current state of the art but the gap between occasionally exaggerated claims of progress and the reality. As to the thrust of the Health For All By The Year 2000 strategy, there can be little doubt that a development strategy based on social justice and active involvement of the population is an efficient tool for propelling a country into the demographic (and epidemiological) transition, for setting in motion or accelerating the movement from high to low mortality. Nevertheless, an egalitarian philosophy "per se" does not guarantee success. Some countries with a less than rigid equity-oriented approach have scored substantial gains, too. The lack of association between infant mortality and measures of inequality such as the Gini coefficient points to the importance of other factors. Another delicate question relates to the long-term applicability and effectiveness of an egalitarian approach to social policy and the organization of society. There is a potential conflict between political and scientific knowledge. In the course of switching from high to low mortality, the social inequality of death has been increasing. Community involvement and the voluntary and determined participation of the population in health intervention programs seem to be--at least in high mortality countries--crucial for advancing along the road to better health. To assume that the import of sophisticated modern technology and financial bilateral or multilateral aid can substitute for national efforts which involve all strata of the population and grant them their fair share of the benefits of development may look like a convenient shortcut for those interested in preserving outdated social structures but is unlikely to succeed. The major determinants of health are deeply rooted in a society, its cultural pattern, politico-institutional philosophy and organization, as well as its economic level.
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  9. 9

    Trends and patterns of mortality in the ESCAP Region: comparative analysis.

    Ruzicka L; Kane P

    In: Mortality and health issues in Asia and the Pacific: report of a seminar held at Beijing in collaboration with the Institute of Population Research, People's University of China from 22 to 27 October 1986. New York, New York, United Nations, 1987. 33-105. (Asian Population Studies Series No. 78.; ST/ESCAP/485.)

    This study outlines the mortality transition in 6 developing countries: Bangladesh, China, Indonesia, Pakistan, the Republic of Korea, and Thailand. The path and pattern of the mortality transition in these countries is compared to the transition in other countries in the Economic and Social Commission for Asia and the Pacific (ESCAP) region. These 6 countries have striking similarities to others in the region: 1) they have all been exposed to colonialism in the past; 2) 30 or 40 years ago they were very similar in their demographic characteristics, and only in the last decade or so have they become increasingly heterogenous; and 3) they have suffered from the stagnation of economic growth and inflation. In at least 1 of the 6 countries, the Republic of Korea, mortality probably started declining early in this century. In Pakistan and Bangladesh, during the British colonial administration of the 1920s, the early decline of mortality was probably limited to urban areas. The onset of the mortality transition is more difficult to date in Thailand and Indonesia, but it probably did not begin before the mid-1940s. It is unlikely that major improvements in Chinese mortality began before the 1950s. In all 6 countries age and sex specific mortality rates declined, though the pattern of these changes varies greatly among them. In most instances, significant reductions in infancy and early childhood mortality occurred, lesser ones among adults, and least affected were older people. In some countries, the reduction of female mortality at some or all ages was proportionately greater than that of males, with a subsequent widening of the gap between the survival chances of males and females. There have been no major changes in the age and sex structure of the 6 populations other than those which have originated from the recent decline in fertility in some of them. The reduced numbers of higher order births, birth spacing, and the postponement of marriage and of births to very young mothers must have reduced infant, child, and maternal mortality. A significant contribution to the general decline of mortality accrues from 2 major trends: 1) rising urbanization, and 2) increasing adult literacy, especially of women. On the available evidence, it appears that in all the countries except Bangladesh the nutritional situation of the population has improved. Health care planning has been an integral part of developmental plans in all 6 countries of the ESCAP region. The health delivery systems in all 6 countries have greatly expanded in the last 35 years. 3 characteristics have made the mortality decline unique: the magnitude, speed, and universality of the decline.
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  10. 10

    Mortality and health issues in Asia and the Pacific: report of a seminar held at Beijing in collaboration with the Institute of Population Research, People's University of China from 22 to 27 October 1986.

    United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]

    New York, New York, United Nations, 1987. vi, 169 p. (Asian Population Studies Series No. 78.; ST/ESCAP/485.)

    The Seminar on Mortality and Health Issues was held at Beijing from 22 to 27 October 1986 as a cooperative venture between the UN Economic and Social Commission for Asia and the Pacific (ESCAP) and the Institute of Population Research, People's University of China, as part of the project, "Analysis of Trends and Patterns of Mortality in the ESCAP Region." Part 1 of the report includes a summary of the Beijing recommendations on health and mortality and the report of the seminar. Part 2 contains papers on a comparative analysis on trends and patterns of mortality in the ESCAP region, an overview of the epidemiological situation in the region, health for all by the year 2000, and inequalities in health.
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  11. 11

    Observations based on the experience of selected countries in the ESCAP region.

    Ruzicka LT

    [Unpublished] 1984. Paper presented at the Meeting on Analysis of Trends and Patterns of Mortality in the ESCAP Region, 13-19 November 1984, Bangkok. [13] p.

    Mortality has declined in all the countries of the Economic and Social Commission for Asia and the Pacific (ESCAP) region, but the declines have been far from uniform. Development may mean greater input into health services and public health, but it can also mean better transportation, more schools, higher wages, more job opportunities, and better housing. Each of these factors affects the health of the population. Mortality decline may be due to either a reduction of exposure to risk or an increased proportion of the population protected from the risk by immunization or other preventive measures. A disease may disappear, such as smallpox has, or a new treatment may substantially reduce case fatalities; both processes may be happening at once. The effective control of "preventable deaths" is the path to modern low mortality levels. Only a few ESCAP countries, those with reasonably accurate cause of death statistics, show modernized mortality levels. Deaths from infectious and parasitic diseases decline with modernization, and deaths from cancer increase. The U-shaped age pattern of mortality, in which infant and child deaths are predominant, becomes a J-shaped curve with greater mortality risk at older ages. Socioeconomic change affects mortality at national, community, and individual or household levels. Life expectancy at birth rises with per capita gross national product. On the individual level, mother's education, family income, family size, and child spacing all affect child mortality. Other sociobiological factors affect mortality risk on an individual level, such as late use of modern health services. Future mortality research needs to examine all these factors and cross discipinary lines.
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  12. 12

    Mortality trends and differentials in selected countries of the ESCAP region.

    Ruzicka LT

    [Unpublished] 1984. Paper presented at the Meeting on Analysis of Trends and Patterns of Mortality in the ESCAP Region, 13-19 November 1984, Bangkok. [23] p.

    In the Economic and Social Commission for Asia and the Pacific (ESCAP) region, life expectancy at birth varies from less than 45 years in Afghanistan, Bhutan, Democratic Kampuchea, Lao People's Democratic Republic, and Nepal to 70 years and above in Japan, Australia, and New Zealand. Generally, mortality has declined in the ESCAP region in the last 25 years. Early mortality improvements can largely be attributed to new disease control technologies, such as immunization and effective disease treatment. Large-scale epidemics became rare, as did large-scale famines. In countries where population was concentrated in urban areas, such as in Singapore and Hong Kong, and in countries where health services were extended to the rural sector, such as China, mortality fell to developed country levels. Health services are not the sole agent in this process; increasing literacy, social welfare policy, adequate housing and water supplies, sanitation, and economic growth are also participants. At the root of mortality differentials between and within countries are problems associated with differential rates of socioeconomic development, income distribution, and the inadequacy of health care systems to cope with their responsibilities. Health services alone may alleviate only some of the major health problems. The sophisticated approach of Western medicine may be inappropriate for these countries. The most prevalent health problems in the least developed countries of the ESCAP region are water and airborne infectious diseases, complicated by malnutrition. Treatment, although bringing immediate relief, may not have a lasting effect on the person who must return to a disease-ridden environment.
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  13. 13

    Mortality and health policy: highlights of the issues in the context of the World Population Plan of Action.

    United Nations. Department of International Economic and Social Affairs. Population Division

    In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 37-79. (International Conference on Population, 1984.; ST/ESA/SER.A/91)

    This paper reviews the major issues that have emerged in the analysis of mortality and health policy since the 1974 World Population Conference. The 1st part summarizes current mortality conditions in the major world regions and evaluates progress toward achieving the goals of the World Population Plan of Action. It is noted that the current mortality situation is characterized by continued wide disparities between the more developed and less developed regions, especially during the 1st year of life. The 2nd part focuses on the synergistic relationship between health and development, including social, economic, and health inequalities. It is asserted that mortality rates in developing countries are a function of the balance governments select between development strategies favoring capital accumulation and concentrated investments on the 1 hand and strategies oriented toward meeting basic needs and reducing inequalities in income and wealth. Data from developed countries suggest that economic development does not necessarily lead to steady gains in life expectancy. Some variations in mortality may reflect changes in family relationships, especially women's status, that are induced by social and economic development, however. The 3rd part of this paper analyzes the effect of health policies on mortality, including curative and preventive programs and primary health care. The lack of community participation is cited as a key factor in the weak performance of primary health care in many developing countries. In addition, there is strong evidence that the concepts and technologies of modern medicine must be adapted to existing systems of disease prevention and care to gain acceptability. The 4th section, on the implementation of health policies, discusses health care management, planning, and financing. It is noted that successful implementation of health policies is often hindered by scarcity, inadequate allocation, and inefficient utilization of health resources. Finally, more effective means to cope with rising costs of health care are needed.
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  14. 14

    Procedures for collecting and analyzing mortality data in LSMS.

    Cochrane SH; Kalsbeek WD; Sullivan JM

    Washington, D.C., World Bank, 1981. 148 p. (LSMS working paper, no. 16)

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  15. 15

    Sex differentials in mortality.

    Lopez AD

    Who Chronicle. 1984; 38(5):217-24.

    As part of its regional strategy for attaining health for all, the World Health Organization (WHO) European Region seeks to reduce sex differentials in mortality. In developing countries, the health consequences of social, economic, and cultural discrimination against females have produced a higher mortality rate among females than males. In contrast, there is a trend toward increasing excess male mortality in the developed countries. The sex differential in mortality arises from 2 broad groups of causes: genetic-biological and enivronmental. In high mortality countries, environmental factors may reduce or cancel out the biological advantages that women enjoy over men. As mortality is reduced through improved nutrition, public health measures, and better health care and education, women's environmental disadvantage is reduced and genetic-biological factors may increase the female life span faster than that of males. In the 3rd phase of this process, life style factors (e.g. alcohol abuse, cigarette smoking) may become increasingly detrimental to male health and survival, leading female mortality to decline at a faster pace than that of males. Although males appear to have adapted less well than women to the stresses of modernization, there has been a trend toward high risk behavior patterns among women too as a result of the changing female role. Prospects for the future trend of sex differentials in developed societies depend largely on developments in 2 areas: the effective treatment of degenerative and chronic diseases, which dominate the cause-of-death structure in these societies; and prevention through health education and encouragement of changes in personal behavior and life style. The challenge for women is to resist pressures to adopt a hazardous life style (e.g. smoking) that might offset the benefits of their improved social status.
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  16. 16

    Mortality trends and prospects in developing countries: some "best-data" indications.

    Stolnitz GJ

    In: United Nations. Department of International Economic and Social Affairs. Population projections: methodology of the United Nations. New York, N.Y., United Nations, 1984. 60-6. (Population Studies, No. 83; ST/ESA/SER.A/83)

    This paper offers suggestions for guiding the next projection's exercise at the United Nations in light of third world life tables which, although severely limited, are believed to be relatively reliable. Of prime importance is the suggestion that expectation of life at birth in a number of less developed areas has begun to overtake and surpass the lower levels of such measures among the populations of developed countries. Although this is the 1st such occurrence on record, it is not likely to be reversed. A major implication of these patterns is that the causal linkages which have historically connected levels and patterns of socioeconomic development with those of mortality have become greatly attenuated. It is safe to say that major new causal mechanisms for reducing mortality have come into play which demographers have yet to comprehend adequately for purposes of projection. Another suggestion is to increase attention to the specific status and performance of national public-sector health programs (including water supply and sanitation) key factors affecting the onset and scale of mortality downtrends during the postwar decades. In addition, increasingly close attention needs to be paid to political disturbances, affecting health-care programs financing and associated delivery systems. With few exceptions, differences between female and male life expectancies at birth have been rising in the sample areas under review, implying that the gains over time for females have been higher than those for males. This directional pattern at both ages is remarkably similar to what has been found to hold with notable consistency among developed countries since 1920. Its prevalence suggests a bench-mark for checing the projected longevity differentials between males and females in the next UN exercise; at a minimum, these should be compared with past directions and magnitudes of change. Added or new attention should be given to comparisons between developed country and less developed country mortality measures; to how such measures vary by age at given points of time and shift by age over time; to sex differentials of both mortality levels and changes; and to the rapidly growing stocks of information becoming available on leading correlates of deaths, survival and morbidity rates. Such attention will enhance the quality, relevance and reliability of the future work of the UN on population projections.
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  17. 17

    [UN/WHO Working Group on Data Bases for Measurement of Levels, Trends and Differentials in Mortality, Bangkok, 20-23 October 1981] Groupe de Travail ONU/OMS sur les Bases des Donnees Destinees a la Mesure des Niveaux, Tendances et Differences dans la Mortalite, Bangkok, 20-23 octobre 1981.

    World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1981; 34(4):239-40.

    The meeting was jointly organized by the UN and the World Health Organization (WHO) to discuss the experience of various governments and national institutions in the collection, analysis, and use of mortality data relevant to the establishment of policies in the health and development sectors of their countries in order to make governments aware of the potential uses of the data. Topics covered included: 1) use of mortality data for health and development programs, 2) use of continuous registration systems, 3) approaches for collection of mortality data, 4) collection of mortality data through multipurpose surveys, 5) birth or death records as a sampling frame for studies of mortality, and 6) special data collection systems for studying health processes. Recommendations concerned vital registration, censuses and surveys, other data needs, research strategies, data management and the role of international organizations and funding agencies, stressing the achievement of "birth and death registration for all by the year 2000" as the final goal.
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  18. 18

    United Nations/World Health Organization Meeting on Socio-Economic Determinants and Consequences of Mortality, Mexico City, 19-25 June 1979.

    United Nations. Department of International Economic and Social Affairs. Population Division; World Health Organization [WHO]

    Population Bulletin. 1980; (13):60-74.

    The objectives of the United Nations/World Health Organization (WHO) Meeting on Socioeconomic Determinants and Consequences of Mortality, held in Mexico City in June 1979, were the following: to review the knowledge of differential mortality and to identify gaps in the understanding of its socioeconomic determinants and consequences; to discuss the methodological and technical problems associated with data collection and analysis; to consider the policy implications of the findings presented and to promote studies on the implications of socioeconomic differentials in mortality on social policy and international development strategies; to formulate recommendations and guidelines for the utilization of the 1980 round of population censuses for in-depth studies of mortality differentials; and to stimulate national and international research on differential mortality. Participants discussed the state of knowledge of socioeconomic differentials and determinants of mortality and described the socioeconomic measures available, the methods of data collection and analysis used, and the findings themselves. A number of characteristics had been employed in the study of differential mortality, and these could be grouped under the following headings: occupation; education; housing; income, wealth; family size; and place of residence. The techniques or methods used to analyze mortality were direct and indirect methods, and these are examined. Inequalities in mortality were found to be closely associated with inequalities in social and economic conditions. Any effort to reduce or remove those inequalities would have to be based on a clear understanding of their causes and interrelationships in order to succeed. Participants indicated a desire to see a resurgence of mortality research, and some research suggestions are outlined.
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  19. 19


    Young CM; Ruzicka LT

    In: United Nations [UN]. Economic and Social Commission for Asia and the Pacific [ESCAP]. Population of Australia. Vol. 1. New York, New York, UN, 1982. 160-82. (Country Monograph Series No. 9; ST/ESCAP/210)

    Major trends in Australian mortality levels and patterns over the past century have included a declining level of mortality, changes in the distribution of the major causes of death, and changing male-female mortality differentials. In 1978, the crude death rate was 7.6/1000 population, the infant mortality rate was 12.2/1000 live births, and average life expectancy was 70.2 years for men and 77.2 years for women. The most frequent causes of death were ischemic heart disease (32.5% of male and 27% of female deaths), cancer (18.9% of male and 18.4% of female deaths), and cerebrovascular diseases (10% of male and 18% of female deaths). These statistics place Australia in the group of countries with the lowest mortality and highest life expectancy. Mortality declines have been greatest at the youngest ages. Most infant mortality is now concentrated in the neonatal period, especially at less than 1 day of age. Differences between male and female mortality rates have widened in recent years, due both to the decreasing significance of deaths among women from maternal causes or infectious diseases and the increasing incidence among men of mortality from accidents, lung cancer, and coronary heart disease. A narrowing gap of mortality has been observed between the states. However, higher infant and overall mortality rates persist in the Northern Territory where the Aboriginal population is concentrated. Although there are no systematic data on urban-rural mortality differentials, studies have found a higher incidence of deaths from pneumonia in the rural areas and greater mortality from lung cancer in the urban centers. The mortality of overseas-born Australians has been noted to converge toward that of native-born Australians the longer their duration of residence in the country. Recent population projections prepared by the Australian Bureau of Statistics include 2 sets of assumptions about future mortality trends. The 1st predicts an infant mortality rate of 7.7/1000 live births by 2001. The 2nd projects an annual 1.5% decline in age-specific mortality rates, resulting in an average life expectancy at birth in the year 2001 of 73.6 years for males and 80.3 years for females. A basic question facing government policymakers is the extent to which the incidence of diseases associated with biological degeneration can be controlled or cured by intervention or life style changes.
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