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Epidemiology - the influence of socioeconomic differences

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Congenital Cytomegalovirus Infection

Abstract

In the last 150 years infant mortality has decreased continuously. In the middle of the nineteenth century, the infant mortality rate was about 160 per 1,000 live births in England, with remarkable differences between largely agricultural counties (rate of 110 per 1,000) and largely industrial counties (rate 163 per 1,000). This rate declined and by the middle of the twentieth century it was about 20–30/1,000 live births [1]. The same situation was apparent in other European regions and the United States [2, 3]. Leading causes of death were atrophy, debility and marasmus; followed by diarrhoea and enteritis; and in third place bronchitis and pneumonia. The association of infant mortality with poverty and unsuitable housing was clear [1, 3]. This situation has not changed, as evidenced by the 2009 World Health Statistics. Globally, an estimated 37 % of deaths among children younger than 5 years occur in the first month of life, most in the first week. Countries making the least progress in reducing infant mortality rates are generally those experiencing high rates of HIV/AIDS, economic hardship or conflict. Disease incidence could be reduced by improved water and sanitation supply. However, because the availability and use of proven interventions at the community level remain low, pneumonia and diarrhoea kills 3.8 million children younger than 5 years annually [4]. Studies analysing infant mortality in the Americas reveal a continuous reduction of infant mortality from 90.34 per 1,000 live births in 1955 to 31.31 in 1995, that is, a reduction of 65 %. Not all countries of the region realised the same reduction. Paraguay, Guyana, Bolivia and Haiti showed a decrease of 41–60 %, while most countries (among others, the United States) saw a reduction between 61 and 80 %. Ten countries had a decrease of more than 80%, with the highest reductions in Cuba (87.65%), Chile (88.33%) and Barbados (93.18%). One of the findings of this study is that social inequalities and disparity in health — two facts closely connected — persist in countries of the Americas Region (regions are designated by the World Health Organisation [WHO]). Government health expenditures in several countries are usually more beneficial for those better off than for the poor, although political will combined with effective public policies could shift the focus of the expenditures towards the poor (as happened in Cuba, Chile and Barbados), thus reducing infants mortality rate as indicator of the general health condition of a population [5].

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Halwachs-Baumann, G. (2011). Epidemiology - the influence of socioeconomic differences. In: Halwachs-Baumann, G. (eds) Congenital Cytomegalovirus Infection. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0208-4_3

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  • DOI: https://doi.org/10.1007/978-3-7091-0208-4_3

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