Health  Vol.8 No.7 , May 2016
An Assessment of Association between Neighborhood Socioeconomic Status and Infant Mortality in High Focus States in India
Abstract: Neighbourhood characteristics influence infant mortality above and beyond individual/household factors. In India, there are very few studies discussing the effects of neighbourhood characteristics on infant mortality. This study examined the effect of neighbourhood socioeconomic characteristics on infant mortality using data from the India’s Third District Level Household Survey conducted in 2007-2008. Multilevel analyses applied on the representative sample of 168,625 nested within 14,193 communities using MCMC procedure. Results established that place of residence, neighbourhood socio-economic factors as important determinants of infant mortality. Overall, being born in affluent (OR: 0.79, p < 0.01), more educated (OR: 0.86, p < 0.01) and socially disadvantaged caste (OR: 0.83, p < 0.01) neighbourhood was associated with the significant reduction in hazards of infant death. The finding of this study suggests that effort should be made to reduce infant mortality in these high focus states by including policies which aim at improving infant survival in the neighbourhood that is economically and socially deprived.
Cite this paper: Gupta, A. and Ladusingh, L. (2016) An Assessment of Association between Neighborhood Socioeconomic Status and Infant Mortality in High Focus States in India. Health, 8, 630-641. doi: 10.4236/health.2016.87066.

[1]   Registrar General of India (2013) SRS Bulletin, Vol. 49, No 1. Vital Statistics Division, Office of the Registrar General of India, New Delhi.

[2]   Reddy, H., Pradhan, M.R., Ghosh, R., et al. (2012) India’s Progress towards the Millennium Development Goals 4 and 5 on Infant and Maternal Mortality. WHO South-East Asia Journal of Public Health, 1, 279-289.

[3]   Bhat, P.N.M. (1987) Mortality in India: Levels, Trends and Patterns. Ph.D. Dissertation, University of Pennsylvania, United States.

[4]   Singh, A., Pathak, P.K., Chauhan, R.K. and Pan, W. (2011) Infant and Child Mortality in India in the Last Two Decades: A Geospatial Analysis. PLoS ONE, 6, e26856.

[5]   Kumar, C., Singh, P.K. and Rai, R.K. (2012) Under-Five Mortality in High Focus States in India: A District Level Geospatial Analysis. PLoS ONE, 7, e37515.

[6]   Fotso, J.C. (2009) What Does Access to Maternal Care Mean among the Urban Poor? Factors Associated with Use of Appropriate Maternal Health Services in the Slum Settlements of Nairobi, Kenya. Maternal and Child Health Journal, 13, 130-137.

[7]   Registrar General of India (2012) Annual Health Survey 2010-2011. Ministry of Home Affairs, Government of India, New Delhi.

[8]   Husain, Z. (2011) Health of the National Rural Health Mission. Economic and Political Weekly, 22, 53-60.

[9]   Kravdal, O. (2004) Child Mortality in India: The Community-Level Effect of Education. Population Studies, 58, 177-192.

[10]   Ladusingh, L. and Singh, C.H. (2006) Place, Community Education, Gender and Child Mortality in North-East India. Population, Space and Place, 12, 65-76.

[11]   Robert, S.A. (1999) Socioeconomic Position and Health: The Independent Contribution of Community Socioeconomic Context. Annual Review of Sociology, 25, 489-516.

[12]   Sastry, N. (1996) Community Characteristics, Individual and Household Attributes, and Child Survival in Brazil. Demography, 33, 211-229.

[13]   Boco, A.G. (2010) Individual and Community Level Effects on Child Mortality: An Analysis of 28 Demographic and Health Surveys in Sub-Saharan Africa. DHS Working Papers No. 73 ICF Macro, Calverton.

[14]   Mosley, W.H. and Chen, L.C. (1984) An Analytical Framework for the Study of Child Survival in Developing Countries. Population and Development Review, 10, 25-45.

[15]   Schultz, T.P. (1984) Studying the Impact of Household Economic and Community Variables on Child Mortality. Population and Development Review, 10, 215-235.

[16]   Pickett, K.E. and Pearl, M. (2001) Multi-level Analyses of Neighborhood Socioeconomic Context and Health Outcomes: A Critical Review. Journal of Epidemiology and Community Health, 55, 111-122.

[17]   Diez, R.A.V. (2001) Investigating Neighborhood and Area Effects on Health. American Journal of Public Health, 91, 1783-1789.

[18]   Balk, D., Pullum, T., Storeygard, A., Greenwell, F. and Neuwman, M. (2004) A Spatial Analysis of Child Mortality in West Africa. Population, Space and Place, 10, 175-216.

[19]   Pradhan, J. and Arokiasamy, P. (2006) High Infant and Child Mortality Rates in Orissa: An Assessment of Major Reasons. Population, Space and Place, 12, 187-200.

[20]   Saikia, N., Singh, A., Jasilionis, D. and Ram, F. (2013) Explaining the Rural-Urban Gap in Infant Mortality in India. Demographic Research, 29, 473-506.

[21]   Rajaratnam, J.K., Burke, J.G. and O’campo, P. (2006) Maternal and Child Health and Neighborhood Context: The Selection and Construction of Area-Level Variables. Health & Place, 12, 547-556.

[22]   Schaefer-Mcdaniel, N., O’brien, C.M., O’campo, P. and Gearey, W. (2010) Examining Methodological Details of Neighbourhood Observations and the Relationship to Health: A Literature Review. Social Science & Medicine, 70, 277-292.

[23]   Antonovsky, A. (1967) Social Class, Life Expectancy and Overall Mortality. The Milbank Memorial Fund Quarterly, 45, 31-73.

[24]   Auerbach, J.A. and Krimgold, B.K. (2001) Income, Socioeconomic Status and Health: Exploring the Relationship. NPA Report, National Policy Association, Washington DC.

[25]   Kawachi, I. and Berkman, L.F. (2003) Neighborhoods and Health. Oxford University Press, New York.

[26]   Aminzadeh, K., Denny, S., Utter, J., Mil-font, T.L., Ameratunga, S., Teevale, T. and Clark, T. (2013) Neighbourhood Social Capital and Adolescent Self-Reported Wellbeing in New Zealand: A Multilevel Analysis. Social Science & Medicine, 84, 13-21.

[27]   Gilbert, N.L., Auger, N., Wilkins, R. and Kramer, M.S. (2013) Neighbourhood Income and Neonatal, Postneonatal and Sudden Infant Death Syndrome (SIDS) Mortality in Canada, 1991-2005. The Canadian Journal of Public Health, 104, e187-e192.

[28]   Becares, L., Cormack, D. and Harris, R. (2013) Ethnic Density and Area Deprivation: Neighborhood Effects on Maori Health and Racial Discrimination in Aotearoa/New Zealand. Social Science & Medicine, 88, 76-82.

[29]   International Institute for Population Sciences (IIPS) (2010) District Level Household and Facility Survey, 2007-2008. IIPS, Mumbai.

[30]   Leckie, G. and Charlton, C. (2013) Runmlwin—A Program to Run the MLwiN Multilevel Modelling Software from within Stata. Journal of Statistical Software, 52, 1-40.

[31]   Caldwell, J.C. (1979) Education as a Factor of Mortality Decline: An Examination of Nigerian Data. Population Studies, 33, 395-413.

[32]   Cleland, J. and van Ginneken, J.V. (1988) Maternal Education and Child Survival in Developing Countries: The Search for Pathways of Influence. Social Science and Medicine, 27, 1357-1368.

[33]   Filmer, D. and Pritchett, L. (1999) The Impact of Public Spending on Health: Does Money Matter? Social Science & Medicine, 49, 1309-1323.

[34]   De Poel, E.V., O’donnell, O. and van Doorslaer, E. (2009) What Explains the Rural-Urban Gap in Infant Mortality: Household or Community Characteristics? Demography, 46, 827-850.

[35]   Bocquier, P., Madise, N.J. and Zulu, E.M. (2011) Is There an Urban Advantage in Child Survival in Sub-Saharan Africa? Evidence from 18 Countries in the 1990s. Demography, 48, 531-558.

[36]   Balarajan, Y., Selvaraj, S. and Subramanian, S.V. (2011) Health Care and Equity in India. Lancet, 377, 505-515.

[37]   Subramanian, S.V., Davey, S.G. and Subramanyam, M. (2006) Indigenous Health and Socioeconomic Status in India. PLoS Medicine, 3, e421.

[38]   Adedini, S.A., Odimegwu, C., Imasiku, E.N.S., Ononokpono, D.N. and Ibisomi, L. (2015) Regional Variations in Infant and Child Mortality in Nigeria: A Multilevel Analysis. Journal of Biosocial Science, 47, 165-187.

[39]   Gunasekaran, S. (2008) Determinants of Infant and Child Mortality in Rural India. Kalpaz Publications, New Delhi.

[40]   Kawachi, I. and Berkman, L.F. (2003) Neighborhoods and Health. Oxford University Press, New York.

[41]   Nayar, K.R. (2007) Social Exclusion, Caste & Health: A Review Based on the Social Determinants Framework. Indian Journal of Medical Research, 126, 355-363.

[42]   Vyas, S. and Kumaranayake, L. (2006) Constructing Socio-Economic Status Indices How to Use Principal Component Analysis. Health Policy and Planning, 21, 459-468.

[43]   Wilkinson, R.G. (1997) Health Inequalities: Relative or Absolute Material Standards. BMJ, 314, 591-595.

[44]   Pamuk, E.R., Fuchs, R. and Lutz, W. (2011) Comparing Relative Effects of Education and Economic Resources on Infant Mortality in Developing Countries. Population and Development Review, 37, 637-664.