Oakley Laura, Maconochie Noreen, Doyle Pat, Dattani Nirupa, Moser Kath
London School of Hygiene and Tropical Medicine.
Health Stat Q. 2009 Summer(42):22-39. doi: 10.1057/hsq.2009.15.
Current health inequality targets include the goal of reducing the differential in infant mortality between social groups. This article reports on a multivariate analysis of risk factors for infant mortality, with specific focus on deprivation and socio-economic status. Data on all singleton live births in England and Wales in 2005-06 were used, and deprivation quintile (Carstairs index) was assigned to each birth using postcode at birth registration. Deprivation had a strong independent effect on infant mortality, risk of death tending to increase with increasing levels of deprivation. The strength of this relationship depended, however, on whether the babies were low birthweight, preterm or small-for-gestational-age. Trends of increasing mortality risk with increasing deprivation were strongest in the postneonatal period. Uniquely, this article reports the number and proportion of all infant deaths which would potentially be avoided if all levels of deprivation were reduced to that of the least deprived group. It estimates that one quarter of all infant deaths would potentially be avoided if deprivation levels were reduced in this way.
当前的健康不平等目标包括减少社会群体之间婴儿死亡率差异这一目标。本文报告了一项关于婴儿死亡率风险因素的多变量分析,特别关注贫困和社会经济地位。使用了2005 - 2006年英格兰和威尔士所有单胎活产的数据,并在出生登记时使用邮政编码为每个出生记录分配贫困五分位数(卡斯尔斯指数)。贫困对婴儿死亡率有强烈的独立影响,死亡风险往往随着贫困程度的增加而上升。然而,这种关系的强度取决于婴儿是否为低出生体重、早产或小于胎龄儿。在新生儿后期,随着贫困程度增加死亡风险上升的趋势最为明显。本文独特之处在于报告了如果将所有贫困水平降低到最不贫困群体的水平,所有婴儿死亡中可能避免的数量和比例。据估计,如果以这种方式降低贫困水平,四分之一的婴儿死亡可能会被避免。