[Infant mortality differentials from congenital malformations with paired data. Chile (1993-1995)]. / Diferenciales de mortalidad infantil por malformaciones congénitas con datos pareados. Chile (1993-1995).

BACKGROUND: The analysis of infant mortality from congenital malformations, which at present is the main group of causes of this mortality in Chile, suggests that it could be decreased with a good knowledge of its conditioning factors. AIM: To study infant mortality differentials from congenital malformations with linked records, in the 1993 to 1995 Chilean birth cohorts. MATERIAL AND METHODS: Analysis of mortality differentials in 1993, 1994 and 1995 birth cohorts. Multivariate logistic regression of mortality from congenital diseases. RESULTS: Univariate analysis showed that mortality is highest in the Southern regions of the country (VII to XII) and in rural areas. It is also higher in children from older and from very young mothers, it increases along with the birth order of the child and decreases with increasing educational level of the mother. Multiple logistic regression analysis, confirmed the higher mortality in the Southern regions, aged mothers, high birth order of the child and low educational level of the mother. However no significant influence of rurality nor greater mortality in children of very young mothers was found. CONCLUSIONS: These results can be attributed to the fact that this type of analysis permits the control with other variables. Although the mortality data showed interesting relationships with the independent variables, a registry of all live births and stillbirths with congenital anomalies, that would provide greater numbers and data on non fatal anomalies, would be desirable to better study their causal factors.

[Infant mortality in Chile: the great descent]. / Mortalidad infantil en Chile: el gran descenso.

Infant mortality in Chile decreased from 120 to 12 per thousand between 1960 and 1994. Outstanding events of this "great descent" are reviewed, based on past research and on updated information. Demographic and socioeconomic changes and improvements in health care that occurred during this period of decline are shown. It is estimated that 30% of the reduction of infant mortality between 1972 and 1982 was due to the decreasing proportion of births of high mortality risk, as a consequence of the fertility decline initiated in the mid 60s. Possible explanations for the continuing decline of infant mortality during the economic crisis of 1975 and 1982 are discussed. Finally, neonatal and postneonatal mortality rates by causes are compared between 1994 and 1980 and causes of death in extreme groups of infant mortality differentials by age of mother, birth order, gestational age, place of residence and educational level of the mother are shown.

[Adult mortality from chronic diseases in Chile, 1968-1990]. / La mortalidad de adultos por enfermedades cronicas en Chile, 1968-1990.

"The paper starts with a brief analysis of the sources and the quality of the data and the mortality indices [for trends in adult mortality from chronic diseases in Chile]....A comparison is made of mortality among the 13 regions of the country and an attempt is made to relate the observed differences to some environmental and life-style factors. Rural-urban and educational differences of mortality by cause of death are also analyzed. The paper ends by comparing mortality by chronic disease in Chile with that of other countries of the Latin American region, noting some difficulties [in] such a comparison and proposing hypotheses for future studies." (SUMMARY IN ENG)

[Has cardiovascular mortality increased in Chile?]. / Ha aumentado la mortalidad cardiovascular en Chile?

From 1975 to 1985 mortality from cardiovascular causes has decreased from 170.6 to 164.5 per 100,000 while its relative participation among all causes has increased from 23.0 to 27.6%. Total cardiovascular and ischemic deaths in the 35 to 74 year age range has also decreased. A lower mortality from ischemic heart disease but a higher one from cerebro vascular disease in all age groups compared to those reported in USA is shown by these data. Differences in the prevalence of risk factors such as diet, hyperlipidemia, hypertension and smoking may underlie this different mortality pattern from cardiovascular disease.

[Fertility and maternal-infant health]. / Fecundidad y salud materno infantil

PIP: The Chilean Association for the protection of the Family was founded 21 years ago in response to serious problems in maternal and child health. A brief history of birth control programs in Chile shows that initial strong government support has been tempered since 1979 by concern over the sharp drop in the birth rate. The number of abortions in Chile has decreased from 28.7/1000 women of reproductive age in 1964 to 11.3/1000 in 1984. Maternal mortality has decreased from 28.6/10000 live births to 3.6/10000 in the same time. Thus these 2 objectives have been very successful. The sharpest decline in the birth rate has been among women over 35 years old, and women of low educational level, indicating perhaps that a greater proportion of children are being born to women most suited to have them. There has been a decrease in the proportion of high risk pregnancies. A high correlation has been found between economic indicators and fecundity, indicating that reproductive behavior is strongly influenced by economic contingencies. Maternal and infant mortality are multifactorial and many different approaches are needed to reduce them. Nevertheless, in the past 20 years, chile has been able to make significant advances in these areas.^ieng

[Chile: mortality between 1 and 4 years of age. Trends and causes]. / Chile: mortalidad de 1 a 4 anos de edad. Tendencias y causas.

PIP: The great decline in infant mortality in Chile in the last 2 decades provokes interest in the current situation in child mortality (for children 1-4 years of age). For the present analysis, central death rates and probabilities of dying are used, calculated with Greville's method from birth and death data. Mortality trends of the group between 1961-78, sex differentials, and causes of death are studied. The findings indicate that mortality in this age group has declined dramatically during the period of analysis, mainly due to the decrease in mortality from respiratory diseases, diarrhea, and diseases avoidable through vaccination. To attain the future approach of the Chilean rate to that of more developed countries, the reduction of mortality from respiratory diseases and diarrhea should continue together with the achievement of substantial reduction in mortality from violence and accidents. This, the primary cause of death in children, ages 1-4, has not varied during the period under study. (author's)^ieng

[Knowledge and use of contraceptives: a comparative analysis with data from reports from Latin American countries]. / Concimiento y uso de metodos anticonceptivos: un analisis comparativo con datos de los informes de paises en America Latina.

PIP: Objective of this paper is to compare data published in the general reports of countries participating in the World Fertility Survey. The major differences encountered were presented by the differences between the surveys of the different countries, in this case Colombia, Costa Rica, Peru, Panama, and the Dominican Republic, and the disparity of classification criteria of the variables considered. For example, age intervals varied in the different countries, as did distribution of women as to place of residence and educational status. Since such variables are strictly related to fertility rate and contraceptive usage, differences must be taken into consideration in the interpretation of results. In all countries considered the proportion of women knowing about contraception was very high; there were, however, great differences in contraceptive usage. Panama and Costa Rica, for example, had high levels of contraceptive use, while Colombia was in an intermediate position, and Peru and the Dominican Republic had low levels. In all countries contraceptive use was higher in urban residents, and in women with better education. Such differences were less noticeable in countries where contraceptive use was higher. Parity had a great influence on contraceptive use, since women with no children had lower levels of contraceptive use than women with higher parity.^ieng

[Infant mortality in Chile]. / La mortalidad infantil en Chile.

PIP: The continuous decrease in infant mortality observed in Chile since 1961 is due mainly to reduction in mortality after 28 days of life. There are 3 main causes to explain this evolation: 1) better standard of life; 2) development of materno-infant programs and of nutrition programs; 3) decrease in birth rate beginning in 1964. Materno-infant programs were instrumental in the control of pregnancies, control of deliveries, treatment of eventual pathologies, and sanitary education of the mother. Respiratory insufficiency and diarrhea, which were years ago major causes of death, have now decreased considerably due to better housing, better socioeconomic conditions, higher educational level of the mother, and more opportunities for medical attention. Users of materno-infant centers also had access to free contraception, and this factor has undoubtedly lowered birth rate among high-risk women, helping to lower infant mortality rate.^ieng

[Infant mortality in Chile]. / La mortalidad infantil en Chile

PIP: The author attempts to identify and explain the determinants of the decline in infant mortality in Chile between 1961 and 1976. The role of maternal, child health, and nutritional programs in the decline is examined. Causes of death, mortality differentials, and the effect of various demographic and socioeconomic variables on infant mortality are analyzed (SUMMARY IN ENG)^ieng

[Mortality in Chile 1955-1975: trends and causes].

PIP: Sources for data on mortality in Chile are available from the Instituto National de Estadistica, and from the Servicio National de Salud. For the purpose of this study every possible effort was made to get valid data, relying on the national death register, and on medical certificates of death. Between 1953 and 1963 the mortality rate was 12-13/1000; it abruptly descended in 1973, and rose again, to reach the level of 7.2/1000 in 1975. Male mortality is higher than female mortality. In the years 1974-1975 the mortality rate descended considerably for infants and for children 1-4. If one compares mortality rates in Chile and Sweden for 1975, it is obvious that modern medical technology and different sanitary conditions are responsible for the low mortality rate in Sweden. As to the causes of mortality, 9 diseases are responsible for more than 90% of deaths. During the past 15 years death from cancer was about 110/1000, while violent deaths and deaths by accidents augmented. The death rate for respiratory diseases decreased significantly in 1974-1975. In comparing causes of death in Chile and in the U.S. one notices that respiratory diseases, infectious diseases, and circulatory diseases account for a great number of deaths in Chile, while in the U.S. accidents account for 73.4% of deaths in the 15-24 year old group. Tuberculosis, which has almost disappeared in the U.S., accounts for 5% of deaths in Chile in the 15-44 year old group. Such differences are due to cultural, social and economic diversity in the structure of the 2 countries. Pneumonia still accounts for 50% of infant mortality, and malnutrition for about 39% of mortality of children under 5. Still, most causes of death, like diarrhea in children, could be avoided with proper diagnosis and treatment. Nutrition, sanitary conditions, medical attention, and socioeconomic conditions are finally responsible if Chilean mortality rates still are much higher than those of developed countries.^ieng