Heaton et al. 2007 + Chen et al. 2016
Heaton et al. 2007
Historical Context
- Conquest by Spaniards
- Massive and expanding political and social disruption
- Serious diseases
- Massacres and enslavement
- Culture of resistance: conscious efforts to preserve their own traditions, language, and culture
- Colonial period: cultural hybridization and domination
- Independence movements of the 1820s
- Resistance to integration and assimilation
- Living conditions and political power of the indigenous people remained low
- Indigenous people: seen as barbarian and inferior, leading to isolation and poverty
- Indigenous culture: seen as primitive, simple, backward technology, and belief in the magical
- Indigenous people are seen as incapable of self-governing, an instrument to be used, and their territory is for exploration
- Decline in infant mortality in Mexico
- Mortality rates are much higher among indigenous people
- Infectious diseases
- Causes: high fertility, young age at initiation of sexual activity, short birth intervals, low maternal education, unsanitary household conditions, and lack of access to health care
Results
- Indigenous speakers score much lower on the socioeconomic index, have less sanitary toilet facilities, and have less education
- Indigenous speakers are more likely to have medical service
- Indigenous groups are more likely to participate in governmental programs designed to improve living conditions of the disadvantaged
Child Mortality Rates
- Rate of child mortality is higher among indigenous groups compared to Mexicans
- Socioeconomic status
- Household conditions
- Important factors:
- Standard of living
- Maternal education
- Number of children
Chen et al. 2016
- US infant mortality rate disadvantage compared to European countries
Results: United States versus Europe
Reporting Differences
- Possible reporting differences for infants born near the threshold of viability
- Many countries have reporting requirements related to birth weight and may not report infants under 500 g as live births
- The presence of assisted reproductive technologies has increased the frequency of multiple births, which have higher mortality rates
Conditions at Birth
- Birth weight in the US is worse than in Finland but close to other countries considered
- Birth weight matters for the US infant mortality disadvantage but previous research may have overstated the importance of this explanation
Timing of the US IMR Disadvantage: Neonatal and Postneonatal Mortality
- The US IMR disadvantage arises in the postneonatal period
- Postneonatal period: from 1 month to 1 year
- Cause: delay of deaths in the US
Causes of Death
- No clear difference in the causes of death
Results: Within-US Evidence
Tremendous variation in infant mortality rates across the United States
United States: has a mortality advantage during the neonatal period
Policy attention: should focus on either preventing preterm births or on reducing postneonatal mortality
Policies should be able to focus on individuals of lower socioeconomic status
Home nurse visits: help to reduce mortality