Social class and infant mortality

This paper examines the relationship between the components of infant mortality and social class by analysing the data available from infant mortality studies undertaken in Western Europe and the United States. A full set of data are given in the Appendix. It was found that although infant mortality has declined dramatically in the past century, the inverse relationship between social class and perinatal, neonatal and postneonatal mortality has not narrowed, in spite of the advances in medicine and surgery, sanitation and housing conditions, and the overall rise in living standards which were presumed to be of special benefit to the lower classes. The large influence of perinatal mortality, and especially stillbirths, on the infant loss rate is discussed.

Several hypotheses to explain the persistence of the social class gap are presented: the “capital assets” thesis; the “time-lag” argument; and the differential social mobility pattern. Finally, data on variables linking social class to infant mortality are briefly reviewed.

Two conclusions are reached. First, that there is a continuing, but unheeded, need for data on class and infant mortality. Second, that the important focus of action, as well as of further research, if the social class gap is to be closed, is less the traditional medical techniques and more the broader issues of social change in education, welfare as well as health services.