Infant Mortality and Socioeconomic Status: Comment on Stockwell Et al.

Abstract

The United States has embarked upon an initiative to eliminate health disparities between advantaged and disadvantaged populations in this country (DHHS 1992(DHHS , 2000. Being able to measure our progress in eliminating these disparities, as well as knowing exactly where and why they exist, requires having reliable data or information to track and monitor changes in health indicators or outcomes. The research done by Stockwell et al. (2005; in this issue) on the relationship between infant mortality and socioeconomic status for whites and nonwhites covering five time periods and four decades for Ohio is an important step towards making that type of information available. Their research is also important for a number of other reasons.Eliminating health disparities requires that we understand how these disparities may vary based on a combination of factors that include race/ethnicity, gender, age, cause of death or incidence of disease, and geography. A dilemma faced by researchers is how to develop stable rates for these types of disaggregations which may result in no cases or a small number of cases, particularly for substate areas. The research by Stockwell and his colleagues provides an example of a simple methodology that can be used by other researchers interested in developing stable rates for small areas (e.g., substate areas), with small numbers of cases. Developing or having methodologies to conduct this type of health research for small areas will become more important as the interest developed on the national level to improve the health of the population shifts to state and substate agencies.While this research focused on metropolitan Ohio, the methodology used would be especially helpful in examining the relationship between socioeconomic status and infant mortality or other health outcomes in rural or nonmetropolitan areas for at least two reasons. The first is to examine the differences or similarities in the observed trends for metropolitan and nonmetropolitan areas.

Socio-Economic Status and Life Expectancy in the United States, 1990-2010: Are We Reaching the Limits of Human Longevity?

“…Finally, with the arrival of census 2010 it will be useful to see if the trends found between 1970 and 1990 changed subsequently to 1990. Such an examination should include race (and ethnicity), for as McGehee (2005) notes, the economic restructuring that has occurred in the United States and the accompanying increase in income inequality, has disproportionately affected minorities. Including these factors would provide a current picture on where the U.S. stands in terms of meeting the "Healthy America 2010" goal of achieving the elimination of health disparities, not only spatially and by SES, but also by one of the other two cornerstones of social stratification in the United States, race (and ethnicity).…”