Are Socio-Economic, Health Infrastructure, and Demographic Factors Associated with Infant Mortality in Russia?

Introduction

The infant mortality rate (< one year old) (IMR) and children mortality (< 5 years old) (CMR) have been declining in the recent decades. According to the Unicef 2012 Report (You et al., 2012), the (CMR) has reduced by 41 percent from 87 deaths per 1,000 live births in 1990 to 51per 1000 live births in 2011; while the IMR has reduced by 39 percent from 61 in 1990 to 37 in 2011. However, it continues to be an international concern. The Millennium Development Goal 4 (MDG 4, UN, 2010) is to reduce the CMR to 29 deaths per 1,000 live births by 2015. Liu et al. (2012) reported that 64% of CMR were related to infectious causes and 40.3% occurred in neonates. Black et al. (2010) reported similar findings. More specifically, You et al (2012) reported the leading causes of CMR deaths are pneumonia (18% of all under-five deaths), preterm birth complications (14%), diarrhea (11%), intrapartum-related complications (9%), and malaria (7%). There are over one-third of CMR deaths attributable to the lack of proper nutrition. Studies (e.g. Chaman, 2012; Diez et al., 2010) suggested that the factors of low birth weight, lack of proper nutrition, inadequate breastfeeding, prenatal smoking are high risk factors associated with CMR at individual level. In comparison with the world, the IMR for USA was 6.39 in 2009 and 6.05 per 1000 live births in 2011(Hoyert & Xu, 2012; Kockanek et al., 2011). The top four causes of IMR for USA were congenital malformations, deformations and chromosomal abnormalities, Disorders related to short gestation and low birth weight, Sudden infant death syndrome and maternal complications (Hoyert & Xu, 2012; Kockanek et al., 2011).

The issues about the CMR and IMR are not only on the causes leading the death for individual cases, but also on what factors; social, economic, environment, education and other; are associated with infant mortality in the society. “WHO WHS 2010 Report” indicated social economic factors such as family income and parental education are highly associated with CMR. The effect on CMR due to the increased education attainment was reported in Gakidou et al. (2010). The data reported by the Unicef 2012 Report (Wardlaw et al., 2012) clearly shows very different level of improvement in CMRs and IMR in different countries. When comparing the rates from 1990 to 2011, developed regions had 15 deaths per 1000 live births in 1990 and 7 in 2011 (55% decrease); while developing regions had 97 in 1990 and 57 in 2011 (41% decrease) for CMR. Similar pattern exists for the IMR. Such a disparity is resulted from many factors combined, including neonatal factors, parental and family factors, social, economic, education and environmental factors, health system, and others.