Inequalities in infant survival: An analysis of Czech linked records

This research analysed individual linked infant birth and death records for the Czech Republic for the years from 1986 to 1992. The study focused on d ifferences in the risk of infant death in a former socialist country where conditions were relatively egalitarian and health care was free. The key va riables analysed included birthweight, gestational age, education level and age of mother, birth order, marital status and age of infant at the time o f death. Despite an expectation of low levels of inequality in infant morta lity, significant differences were found that were related to the level of mothers' education. In addition, infant mortality increased with birth orde r of the child in the postneonatal period and for normal birthweight infant s (even when controlling for other variables). These anomalies, we believe, have a significant socio-economic root and not a biological relationship. The inverted pattern in infant mortality for low birthweight babies found a mong Afro-American women in the U.S was also found for women with low level s of education within the ethnically homogeneous Czech population. Similar patterns were replicated at regional levels in the Czech Republic. Surprisi ngly, two very contrasting regions (in terms of socio-economic development and functions) - Prague and Ceske Budejovice - were found to have the highe st risk of infant death, characterized primarily by increased risk for infa nts in the ``normal'' or usually low risk categories.