Patterns of mortality in childhood: report of the Inter-American Investigation of Mortality in Childhood.
The Inter-American Investigation of Mortality in Childhood, a collaborative research project coordinated by the Pan American Health Organization, was based on data collection projects in 15 areas--1 in the US, 1 in Canada, and the others in Latin America. 35,095 deaths in children under 5 years of age were studied in these 15 different projects. Patterns in each area were distinct. Nutritional deficiency, especially when combined with low birth weight, was found to be the most serious health problem contributing to early mortality. More than 1/2 the children who died were found to have had immaturity or nutritional deficiency as either an underlying or as associated cause. The study data also highlighted the synergism between infection and nutritional status, emphasizing the importance of immunization programs. Nutritional deficiency-related mortality peaked in infancy, as early as the 3rd or 4th months. Study findings point up the deficiencies in health-related statistics collection in many of these project areas. Other factors such as breast feeding, prenatal care for the mother, and socioeconomic characteristics of the family were found to be associated with mortality levels. Proper prenatal programs, it is felt, could help prevent low birth weight and initial nutritional deficiency, both of which are easier to prevent than to correct.