Socioeconomic inequalities in perinatal and infant mortality from 1854 to 1990 in Amsterdam, the Netherlands

Abstract

Trends in socioeconomic differences in infant and perinatal mortality in Amsterdam were studied for the period 1854-1990, using published and unpublished material, at the aggregate and at the individual level. Absolute and relative socioeconomic mortality differences (SEMD) per data-set were calculated using inequality indices developed by Pamuk. The results show a decrease of the absolute differences in both infant and perinatal mortality. For infant mortality, this is mainly due to the overall decline of the infant mortality rate. Relative differences in infant mortality did not decrease during the study period. This is the result of separate developments in 3 time periods. From approximately 1850 to approximately 1910 an increase in relative differences can be seen, a trend which is reversed from approximately 1910 to the end of World War II. After World War II relative differences seem to stabilize at the same level. For perinatal mortality, for which only data from the post-World War II period are available, the decrease in the absolute differences is due both to the overall decline of the perinatal mortality rate and to a decline of relative differences between socioeconomic groups. It is concluded that although SEMD in infant and perinatal mortality have declined in an absolute sense, they still exist and that the relative position of deprived groups concerning infant mortality was not ameliorated during the study period.