CHILD SURVIVAL IN BEIRUT DURING WARTIME - TIME TRENDS AND SOCIORELIGIOUS DIFFERENTIALS

Background. Child mortality estimates in Beirut are presented for the late 1970s and the mid 1980s, and changes in socio-religious different ials of mortality across time are investigated. Methods. Baseline info rmation was obtained from maternity registries in Beirut in 1984 and 1 991. Age of mother, number of children ever born and number of childre n alive, hospitalization class (1, 2 or 3 within each hospital, depend ing on the room rate, the services and the doctor's fees), and religio n of newborn was recorded. Brass and Macrae's technique was used to co nvert the proportion dead among children ever born to mothers in age g roup 30-34 into (5)q(0) estimates for the reference periods 1978 (1984 data) and 1985 (1991 data). Using hospitalization class as a proxy fo r social class, religious differentials in child mortality were explor ed by logistic regression analysis within each period. Results. Overal l, (5)q(0) is estimated at 46 per 1000 in the late 1970s, and at 36 pe r 1000 in the mid 1980s. The religious differentials in (5)q(0) mortal ity estimates were quite large in the former period, with a risk for M uslims relative to Christians of 1.53, which declined to 1.35 in the l atter period. The regression analysis of the proportion dead among chi ldren ever born; (1) confirmed the magnitude of the religious differen tials in child mortality, and their reduction over time; (2) demonstra ted the existence of an interaction between religion and social class, as the religious differentials in child mortality were found to be hi ghly prevalent in the lower social classes, and almost insignificant i n the middle and upper ones; (3) highlighted the decisive role of diff erential fertility in generating differential chili mortality, with hi gher fertility and higher child mortality in Muslims, and with the dis appearance of religious differentials in child mortality after adjustm ent for fertility. Conclusion. The findings confirm the hypothesis of a reduction over time of religious-based child mortality differences i n the capital city of Lebanon, in agreement with the pattern found for religious-based fertility differences. Comparisons with other countri es in the region indicate that the war in Lebanon has slowed down the decline in child mortality, causing the country to loose its priviledg ed position among Arab countries.