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Economic Disparity and Child Survival in Cambodia
R. Hong, MD, DrPH
Demographic and Health Research Division, ORC Macro, USA, rathavuth.hong{at}orcmacro.com
V. Mishra, MPH, PhD
Demographic and Health Research Division, ORC Macro, USA
J. Michael, ScD, DrPH
School of Public Health and Health Services, George Washington University, USA
Despite improvements in child survival in recent decades, levels of infant and child mortality remain unacceptably high, particularly among the poor in developing countries recovering from recent wars and civil unrests. Using information on 8,498 childbirths in five years preceding the 2000 Cambodia Demographic and Health Survey, this study measured the association between economic disparity and infant mortality using multivariate Weibull regression. Results indicate that children born in the poorest 40% households were more than twice as likely to die during infancy as those born in the richest 20% households, even after controlling for pregnancy care, birth weight, household living conditions, and other factors. Children born in the middle-income households also had significantly higher mortality risks. Not receiving antenatal care and low birth weight were associated with an increased risk. Also, boys had a higher risk than girls. The study concludes that poverty is strongly negatively associated with infant survival in Cambodia. Asia Pac J Public Health 2007; 19(2): 37-44.
Key Words: Cambodia • child survival • economic disparity • infant mortality • low birth weight • poverty • wealth index.
References
- United Nation Development Programme. Human Development Report 2004. New York (NY): UNDP, 2004.
- World Bank. World Development Report 2000. Washington (DC): World Bank, 2000.
- Macassa G., Ghilagaber G., Bernhardt E., Diderichsen F., Burstrom B. Inequalities in child mortality in Mozambique: differentials by parental socio-economic position. Soc Sci Med 2003;57:2255-64.[CrossRef][Medline]
[Order article via Infotrieve]
- Garenne ML, Coninx R., Dupuy C. Effects of the civil war in central Mozambique and evaluation of the intervention of the International Committee of the Red Cross. J Trop Paediatr 1997; 43: 318-23.[Free Full Text]
- Thang NM, Popkin BM In an era of economic growth, is inequity holding back reduction in child malnutrition in Vietnam? Asia Pac J Clin Nutr 2003; 12: 405-10.[Medline]
[Order article via Infotrieve]
- Zere E., McIntyre D. Inequities in under-five child malnutrition in South Africa. Intl J Equity Health 2003; 2:7.
- Macassa G., Ghilagaber G., Bernhardt E., Burstrom B. Trends in infant and child mortality in Mozambique during and after a period of conflict. Public Health 2003; 117: 221-7.[CrossRef][Medline]
[Order article via Infotrieve]
- World Health Organization, Regional Office of Western Pacific. Western Pacific Country Health Information Profiles 2004 Revision. Manila: WHO-WPRO, 2004.
- Ross NA, Wolfson MC, Dunn JR, Berthelot J., Kaplan GA, Lynch JW Relation between income inequality and mortality in Canada and in the United States: cross sectional assessment using census data and vital statistics. BMJ 2000; 320: 898-902.[Abstract/Free Full Text]
- Pelletier DL, Frongillo EA Changes in child survival are strongly associated with changes in malnutrition in developing countries. J Nutr 2003; 133: 107-19.[Abstract/Free Full Text]
- Rice AL, Sacco L., Hyder A., Black RE Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries. Bull World Health Organ 2000; 78: 1207-21.[Web of Science][Medline]
[Order article via Infotrieve]
- Pena R. Wall S. Persson LA The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua 1988-1993. Am J Public Health 2000; 90: 64-9.[Abstract/Free Full Text]
- Gupta R., Gupta BD, Singh RN, Mehta SC Infant mortality-critical analysis of factors and new approach for calculation of I.M.R. Indian J Matern Child Health 1991; 2: 72-8.[Medline]
[Order article via Infotrieve]
- Shmueli A. Population health and income inequality: new evidence from Israeli time-series analysis. Int J Epidemiol 2004; 33:311-7.[Abstract/Free Full Text]
- HillemeierMM, Lynch J., Harper S., Raghunathan T., Kaplan GA Relative or absolute standards for child poverty: a state-level analysis of infant and child mortality. Am J Public Health 2003; 93: 652-7.[Abstract/Free Full Text]
- Kiros GE, Hogan DP War, famine and excess child mortality in Africa: the role of parental education. Int J Epidemiol 2001; 30: 447-55.[Abstract/Free Full Text]
- Cutts FT, Dos Santos C, Novoa A., David P., Macassa G., Soares AC Child and maternal mortality during a period of conflict in Beira City, Mozambique. Int J Epidemiol 1996; 25: 349-56.[Abstract/Free Full Text]
- Choe MK, Luther NY, Pandey A., Sahu D., Chand J. Identifying children with high mortality risk. Natl Family Health Surv Bull 1999; 12: 1-4.
- National Institute of Statistics (NIS), Directorate General of Health (DGH) and Macro International Inc. Cambodia Demographic and Health Survey 2000. Calverton MD: NIS, DGH and Macro International Inc, 2001.
- Rutstein SO, Rojas G. Guide to DHS statistics. Calverton (MD): ORC Macro, 2003.
- Hong R. Inequality in Health and Health Care in Cambodia. DrPH dissertation. Washington (DC): George Washington University, 2002.
- Gerlter PJ, Rose E., Glewwe P. Health. In: Grosh M, Glewwe P, (editors). (Designing Household Survey. Questionnaires of Developing Countries. Lessons Learn from 15 Year of the Living Standards Measurement Study.) Washington (DC): World Bank 2000: 177-216.
- Berkman LK, Kawachi I. Social Epidemiology. New York (NY): Oxford University Press, 2000.
- Stata Corporation, Inc. STATA Release 8.1. College Station (TX): Stata Press, 2003.
- Melve KK Skjaerven R. Birth-weight and perinatal mortality: paradoxes, social class, and sibling dependencies. Inter J Epidemiol 2003; 32: 625-32.[Abstract/Free Full Text]
- Defo BK Areal and socioeconomic differentials in infant and child mortality in Cameroon. Soc Sci Med 1996; 42: 399-420.[CrossRef][Medline]
[Order article via Infotrieve]
- Escobar GJ, Littenberg B., Petitti DB Outcome among surviving very low birth-weight infants: a meta-analysis. Arch Dis Child 1991; 66: 204-11.[Abstract/Free Full Text]
- Wells JC Natural selection and sex differences in morbidity and mortality in early life. J Theor Biol 2000; 202: 65-76.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Peña R., Wall S., Persson L. The effect of poverty, social inequality, and maternal education on infant mortality in Nicaragua, 1988-1993. Am J Public Health 2000; 90: 64-9.[Abstract/Free Full Text]
- Casa JA, Dachs N., Bambas A. Health Disparities in Latin America and the Caribbean: The Role of Social and Economic Determinants. In: Equity and health. Washington (DC): Pan American Health Organization, 2001: 22-49.
- Filmer D., Pritchett L. Estimating Wealth Effects without Expenditure Data or Tears: An Application to Educational Enrollment in States of India. Policy Research Working Paper Number 1994. Washington (DC): World Bank, 1988.
- Rutstein, SO, Johnson K. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, MD: ORC Macro, 2003.
Asia-Pacific Journal of Public Health, Vol. 19, No. 2,
37-44 (2007)
DOI: 10.1177/10105395070190020701
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