BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

Chapter VII
Mortality in Early Childhood
The excessive mortality recorded in Latin
America for early childhood (as well as
infancy) led to the specific recommendations
for action that were adopted by the
countries in the Charter of Punta del Este
(Organization of American States, 1961).
The period of early childhood (age 1-4
years) is the one in which mortality can be
reduced to very low levels through application
of existing knowledge. Studies of iortality
in this age group, however, must take
into account the experiences of infants in
the first year of life, which to a great extent
determine future health. their
The
chances
infant is
of
not
survival
necessaril
and
healthy on reaching the first birthday, and
in particular nutritional deficiencies may
already be well established in many children
by the time they reach late infancy and
early childhood, as a result of poor intake
of nutrients and/or repeated episodes of
infectious diseases.
Horwitz (1960) used data for eight countries
of the Americas to illustrate the excessive
mortality in the age period 1-4 years,
and singled out four socioeconomic values
as having an inverse relation to mortality:
countries with high death rates had low
values in terms of availability of animal
protein, provision of water supplies, percapita
income, and literacy levels. Even
the crude data for the countries, without
123
consideration of differences in urban and
rural areas, clearly revealed the interrelationships.
Horwitz pointed out that the
problems' solution depended on a 1'oad
program for socioeconomic developmen .1s
well as on specific health programs.
The data provided by this Investigation
on mortality in relation to these socioeconomic
values are much more complete and
reliable than those previously available.
However, data on per-capita income obtained
from families were found to be inadequate
in the pilot phase of the Investigation
and
mortality
were
by
not
multiple
included.
causes
The
has
analysis
uncovered
of
information on the effect of lack of protein
and calories, as reflected in the data on
nutritional deficiency as a cause of (leath.
Recent studies by Kitagawa and Hausel
(1968) and Rosenwaike (1971) indicate the
usefulness of referring to educational level
of the niother as an overall measure of
socioeconomic variables in relation to child
mortality. In Chapter XIV mortality in
early childhood is analyzed in relation to
the mother's educational level. In Chapter
XVI infant mortality is considered in relation
to environmental factors, especially
provision of water supplies.
This chapter present,, first a broad view
of mortality in this four-year age group, and
then an analysis of mortality in the second
year of life, a critical age period in develop­