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Korean Journal of Epidemiology 1990;12(1): 57-80.
우리나라 영아사망률의 최근 추세와 그 결정요인 분석
한성현, 김일순
Recent trends of infant death rates and its determinants in Korea
Seung Hyung Han, Il Soon Kim
Abstract
The purpose of this research was to estimate the infant mortality rates in Korea and to determine related factors. For the study, data from the National Fertility and Family Health Survey conducted by Korea Institute for Population and Health in 1988 was analyzed. The units of analysis were all births that occurred after 1974 from 7922 married women. The specific objectives of this research were, firstly, to calculate annual infant, perinatal death rates by fiscal years, and secondly, to identify determinants of infant death by applying the proportional hazard model and logistic regression model. The results of the study are summarized below. 1. Infant death rates declined from 28.4 in 1974-1975 to 13.9 in 1984-1985, perinatal death rates from 28.2 to 15.3, and neonatal death rates from 19.8 to 11.2(rates per 1,000 births). 2. By applying the proportional hazard model and multiple logistic analyses to the data from all births after 1974, residence, parity, the experience of infant death, occupation and inter-birth interval were shown to be significant risk factors, while the data from the birth cohorts of 1980-1987 showed that only parity and residence were significant and their relative risks were above 2. By analyzing the data from the last births after 1983, parity, residence, inter-birth interval and occupation of the head of the household were shown to be significant and the relative risk of the vaccination status of children was 2.2 and proved to be the most important factor. To sum up the results, the infant death rates showed a steep decline during the period between the latter part of 1970's and the earlier part of 1980’s, mainly due to the rapid economic and social development of Korea and to the decrease in fertility caused by population control policies in the 1970's. Other effective health care policies expedited such a decline. After the middle of the 1980’s, the speed of descent seemed to slow down. Strong policies for maternal child health care are required in order to bring the level of infant death rates to 6, which are considered to be the lowest rates that can be achieved by modern medicine. One of the reasons why the infant death rates are still high in rural areas and in mothers of high parity can be explained by the fact that they belong to a higher risk group and have been excluded from maternal-child health care programs.


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