The 130th Annual Meeting of APHA

Abstract #41231

Nyovani J Madise, PhD¹, Alison Whitworth, PhD², and Zoë Matthews, PhD¹. (1) Department of Social Statistics, University of Southampton, Highfield, Southampton, SO17 1BJ, United Kingdom, 011-44-2380592534, njm@socsci.soton.ac.uk, (2) Office for National Statistics, Titchfield, Fareham, Portsmouth, Po15 5RR, United Kingdom

There is now strong evidence of clustering of infant deaths within families and evidence that the degree of clustering varies between countries. However, explanations for familial correlation of mortality and the strength of this correlation are so far only speculative. Thus, the contribution of a large-scale comparison of data from different regions of the developing world is important in understanding why death clustering is stronger in some areas than others. Demographic and health data from twelve Indian states and twelve African countries are used in multilevel modelling to quantify the degree of clustering of infant mortality at family level while controlling for a range of bio-demographic, socio-economic, and community variables. State or country-level economic variables such as income inequality, and health provision indicators are used to see if they explain infant death clustering.

The results of the preliminary analysis indicate that membership of a particular family is important as a determinant of mortality risk. Possible explanations fall into four main categories: genetic (e.g. susceptibility to disease), the family’s health related behaviour (e.g. use of health services), parental competence in childcare (e.g. child feeding practices) and household economic status. This analysis shows that different levels of clustering of health outcomes are observed across countries with varying levels of economic development and infrastructure. The search for explanations of family heterogeneity should not, therefore, be limited to genetic and behavioural factors but should explore broader economic causes.

Learning Objectives:

• At the end of the session, participants will be able to
• a) compare and contrast the determinants of infant mortality in selected India and African countries;
• b) assess the link between death clustering and the level of socio-economic development and health provision in India and Africa;
• c) identify the possible causes of clustering of deaths among Indian and African households.

Keywords: Child Health, International Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.