CHANGES IN INFANT-MORTALITY RATES AMONG WHITES, COLOREDS AND URBAN BLACKS IN THE RSA OVER THE PERIOD 1970-1983

  • 1 January 1985
    • journal article
    • research article
    • Vol. 68  (4) , 215-218
Abstract
Using national mortality statistics, we found that infant mortality rates (IMRs) declined among whites and coloureds in the RSA over the period 1970-1983, the decrease in coloured IMR being from 134.8 to 50,7/1,000 and that in white IMR from 21,6 to 12,6/1,000. The decrease in the IMR among coloureds was mainly due to the decline in post-neonatal mortality rates (PNMRs). Since post-neonatal deaths are generally due to gastro-enteritis, pneumonia, malnutrition and measles, the decline in mortality is probably due to a decrease in these causes. The decrease in early neonatal mortality made only a small contribution to the decline in the IMR among coloureds. In the case of whites the decrease in the IMR was largely due to the decline in the early neonatal mortality rate (ENMR); these deaths usually result from low birth weight, the respiratory distress syndrome, asphyxia and infections. The decline in the PNMR played a minor role. National IMRs for blacks are not reported annually, but IMRs can be calculated for the two census years 1970 and 1980 for blacks in 34 ''selected'' (urban) magisterial districts, and were 124,4 and 85,9/1,000, respectively. A valid IMR for ''rural'' Transkel from a well-conducted epidemiological study was 130/1,000 in 1980. The components of the IMRs for blacks can only be determined for certain urban areas with large black populations such as Soweto (ajacent to Johannesburg), where the IMR fell from 81,4/1,000 in 1970 to 25,5/1,000 in 1983. The decline in the IMR was due to decreases in both the ENMR and the PNMR. The findings of Soweto blacks cannot be generalized to all urban blacks. The beneficial effects of urbanization in cities with good health services on the health of coloured and black infants are shown firstly among coloureds, with a national IMB of 50,7/1,000 in 1983 compared with an IMR in Cape Town of 19,3/1,000, and secondaly among blacks, with an IMR in rural Transkel of 130/1,000 in 1980 compared with an IMR of 25,5/1,000 in Soweto in 1983. The relative roles of health services and socio-economic conditions on the low IMRs in these two cites need further in-depth study. Large differences in the IMRs between blacks and coloureds on the one hand and whites on the other still exist in the 1980s and emphasize the urgent need for preventive measure to reduce IMRs in the black and coloured communities along the lines of the UNICEF recommendations. The different strategies needed for whites, coloureds and blacks are discussed.

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