Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112711

Mian B. Hossain, MSC, MHS, PhD, MPH/DrPH Public Health Program, Morgan State University, 343 Jenkins Building, 1700 E. Cold Spring Lane, Baltimore, MD 21251-0001, 443-885-4132, mbhossain@moac.morgan.edu and James Phillips, PhD, Policy Research Division, Population Council, 1 Dag Hammarskjold Plaza, New York, NY 10017.

Childhood mortality has been shown to covary with fertility levels in several settings. The causal structure of the relationship between child mortality events and subsequent fertility, however, is often poorly understood. This paper addresses this issue with an analysis of twelve years of prospective longitudinal data on births and childhood deaths occurring to nearly 8,000 mothers observed in the Bangladesh Operations Research Project at International Center for Diarrhoeal Disease Research, Bangladesh. Observations span the 1982 to 1993 period, a time in the recent history of Bangladesh in which both childhood mortality and fertility were declining. Proportional hazard regression analysis is employed to assess the effect of infant and child mortality on the hazard of conception, controlling for birth order and maternal age and educational attainment. Results show that childhood mortality increases the hazard of birth interval closure if the death occurs in the index interval, representing a combined biological and volitional replacement effect and also if the death occurs in a prior birth interval, signifying a volitional replacement effect alone. Moreover, mortality effects in prior birth intervals are consistent with the hypothesis of insurance effects. Interaction of replacement with time period suggests that the volitional impact of child mortality increases as demographic transition progresses. This volitional effect is more pronounced if the index child is male. However, the interaction of gender of index child with replacement is independent of the stage of transition. Although gender bias interacts with child replacement, this relationship has not changed with time.

Learning Objectives: At the conclusion of the session, the participants in this session will be able to

• Understand the the level of infant-child mortality and fertility in developing country
• Understand the association between infant-child mortality and subsequent fertility
• Understand mechanism for controling fertility by improving health of the children and develop policy accordingly

Keywords: Mortality, Child Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.