Abstract
This paper presents an analysis of the relationship between community characteristics, household attributes, and child survival in Brazil. The principal objectives are to investigate how the social and environmental context in which a child is raised affects his or her survival chances, and to analyze how household variables modify the effects of community characteristics. The interaction effects we examine help to explain the effects of community characteristics on child survival chances by illuminating the most likely pathways through which these covariates operate. This information is also useful for predicting who is most likely to benefit from public policies to improve community infrastructure. education, and health care.
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References
Arruda, J.M., Rutenberg, N., Morris, L., & Ferraz, E. (
1987
). Pesquisa Nacional Sobre Saúde Materno-Infantil e Planejamento Familiar—Brasil, 1986
. Rio de Janeiro
: BEMFAM/IRD
.Banta, H.D. (
1986
). Medical Technology and Developing Countries: The Case of Brazil
. International Journal of Health Services
, 16
, 363
–73
. 10.2190/7H41-XEEB-AQYY-0CN6Barnum, H., & Kutzin, J. (
1993
). Public Hospitals in Developing Countries: Resource Use, Cost, Financing
. Baltimore
: Johns Hopkins University Press
.Barrera, A. (
1990
). The Role of Maternal Schooling and Its Interaction with Public Health Programs in Child Health Production
. Journal of Development Economics
, 32
, 69
–91
. 10.1016/0304-3878(90)90052-DBarros, F.C., & Victora, C.G. (
1990
). Breastfeeding and Diarrhea in Brazilian Children
. Columbia, MD
: Macro International
.Barros, R., & Sawyer, D.O. (
1991
). Unequal Opportunities to Survive, Education and Regional Disparities in Brazil
. Rio de Janeiro
: IPEA
.Benefo, K.D. and T.P. Schultz. 1994. “Determinants of Fertility and Child Mortality in Côte d’Ivoire and Ghana.” LSMS Working Paper 103, World Bank.
Bourne, P. (
1984
). Water and Sanitation for All
. In Bourne, P. (Ed.), Water and Sanitation: Economic and Sociological Perspectives
(pp. 1
–20
). Orlando
: Academic Press
.Brockerhoff, M. (
1990
). Rural-to-Urban Migration and Child Survival in Senegal
. Demography
, 27
, 601
–16
. 10.2307/2061573Butz, W.P., Habicht, J.-P., & DaVanzo, J. (
1984
). Environmental Factors in the Relationship between Breastfeeding and Infant Mortality: The Role of Sanitation and Water in Malaysia
. American Journal of Epidemiology
, 119
, 516
–25
.Caldwell, J.C. (
1979
). Education as a Factor in Mortality Decline: An Examination of Nigerian Data
. Population Studies
, 33
, 395
–413
. 10.2307/2173888Carvalho, J.A.M., & Wood, C.H. (
1978
). Mortality, Income Distribution and Rural-Urban Residence in Brazil
. Population and Development Review
, 4
, 405
–20
. 10.2307/1972857Casterline, J.B., Cooksey, E.C., & Ismail, A.F.E. (
1989
). Household Income and Child Survival in Egypt
. Demography
, 26
, 15
–35
. 10.2307/2061491Clayton, D.G. (
1978
). A Model for Association in Bivariate Life Tables and Its Application in Epidemiological Studies of Familial Tendency in Chronic Disease Incidence
. Biometrika
, 65
, 141
–51
. 10.1093/biomet/65.1.141Cleland, J.G. (
1990
). Maternal Education and Child Survival: Further Evidence and Explanations
. In Caldwell, J., Findley, S., Caldwell, P., Santow, G., Cosford, W., Braid, J., & Broers-Freeman, D. (Eds.), What We Know about Health Transition: The Cultural, Social and Behavioral Determinants of Health
(pp. 400
–19
). Canberra
: Australian National University
.Cleland, J.G., & van Ginneken, J.K. (
1988
). Maternal Education and Child Survival in Developing Countries: The Search for Pathways of Influence
. Social Science and Medicine
, 27
, 1357
–68
. 10.1016/0277-9536(88)90201-8Cox, D.R. (
1972
). Regression Models and Life Tables (with Discussion)
. Journal of the Royal Statistical Society
, 34
, 187
–220
.Curtis, S.L., & McDonald, J.W. (
1991
). Birth Spacing and Infant Mortality in Brazil
. Journal of Biosocial Science
, 23
, 343
–52
. 10.1017/S0021932000019404Daly, H.E. (
1985
). Marx and Malthus in Northeast Brazil: A Note on the World’s Largest Class Difference in Fertility and Its Recent Trends
. Population Studies
, 39
, 329
–338
. 10.1080/0032472031000141516Das Gupta, M. (
1990
). Death Clustering, Mothers’ Education and the Determinants of Child Mortality in Rural Punjab, India
. Population Studies
, 44
, 489
–505
. 10.1080/0032472031000144866DaVanzo, J. (
1988
). Infant Mortality and Socioeconomic Development: Evidence from Malaysian Household Data
. Demography
, 25
, 581
–95
. 10.2307/2061323DaVanzo, J., & Habicht, J-P. (
1986
). Infant Mortality Decline in Malaysia, 1946–1975: The Roles of Changes in Variables and Changes in the Structure of Relationships
. Demography
, 23
, 143
–60
. 10.2307/2061613Denslow, D., & Tyler, W. (
1984
). Perspectives on Poverty and Income Inequality in Brazil
. World Development
, 12
, 1019
–28
. 10.1016/0305-750X(84)90027-5Esrey, S.A., & Habicht, J-P. (
1986
). Epidemiologic Evidence for Health Benefits from Improved Water Supply and Sanitation in Developing Countries
. Epidemiology Review
, 8
, 117
–28
.Esrey, S.A., & Habicht, J-P. (
1988
). Maternal Literacy Modifies the Effect of Toilets and Piped Water on Infant Survival in Malaysia
. American Journal of Epidemiology
, 127
, 1079
–87
.Farah, A.A., & Preston, S.H. (
1985
). Child Mortality Differentials in Sudan
. Population and Development Review
, 8
, 365
–83
. 10.2307/1972992Goldberg, H.I., Rodrigues, W., Thome, A.M.T., Janowitz, B., & Morris, L. (
1984
). Infant Mortality and Breastfeeding in Northeastern Brazil
. Population Studies
, 38
, 105
–15
. 10.2307/2174357Guo, G., & Rodríguez, G. (
1992
). Estimating a Multivariate Proportional Hazards Model for Clustered Data Using the EM Algorithm, with an Application to Child Survival in Guatemala
. Journal of the American Statistical Association
, 87
, 969
–76
. 10.2307/2290633Habicht, J-P., DaVanzo, J., & Butz, W.P. (
1988
). Mother’s Milk and Sewage: Their Interactive Effects on Infant Mortality
. Pediatrics
, 81
, 456
–61
.Hobcraft, J.N., McDonald, J.W., & Rutstein, S.O. (
1985
). Demographic Determinants of Infant and Early Child Mortality: A Comparative Analysis
. Population Studies
, 39
, 363
–85
. 10.1080/0032472031000141576Holford, T.R. (
1980
). The Analysis of Rates and Survivorship Using Log-Linear Models
. Biometrics
, 36
, 299
–306
. 10.2307/2529982Laird, N., & Olivier, D. (
1981
). Covariate Analysis of Censored Survival Data Using Log-Linear Analysis Techniques
. Journal of the American Statistical Association
, 76
, 231
–40
. 10.2307/2287816Lindenbaum, S., Chakraborty, M., & Elias, M. (
1989
). The Influence of Maternal Education on Infant and Child Survival in Bangladesh
. In Caldwell, J.C., & Santow, G. (Eds.), Selected Readings in the Cultural, Social and Behavioral Determinants of Health
(pp. 112
–31
). Canberra
: Australian National University
.Mensch, B., Lentzner, H., & Preston, S.H. (
1985
). Socioeconomic Differentials in Child Mortality in Developing Countries
. New York
: United Nations
.Merrick, T.W. (
1985
). The Effect of Piped Water on Early Childhood Mortality in Urban Brazil, 1970 to 1976
. Demography
, 22
, 1
–23
. 10.2307/2060983Merrick, T.W. (
1986
). A População Brasileira a Partir de 1945. In Bacha, E., & Klein, H.S. (Eds.), A Transição Incompleta
(pp. 11
–19
). Rio de Janeiro
: Paz e Terra
.Miller, J.E., Trussell, J., Pebley, A.R., & Vaughan, B. (
1992
). Birth Spacing and Child Mortality in Bangladesh and the Philippines: How Much Is Explained by Gestation?
. Demography
, 29
, 305
–18
. 10.2307/2061733Mosley, W.H. 1984. “Child Survival: Research and Policy.” Pp. 1024 in Child Survival: Strategies for Research, edited by W.H. Mosley and L.C. Chen. Supplement to Population and Development Review 10.
Mosley, W.H. and L.C. Chen, 1984. “An Analytical Framework for the Study of Child Survival in Developing Countries.” Pp. 25–48 in Child Survival: Strategies for Research, edited by W.H. Mosley and L.C. Chen. Supplement to Population and Development Review 10.
Oakes, D. (
1982
). A Model for Association in Bivariate Survival Data
. Journal of the Royal Statistical Society
, 44
, 414
–22
.Health Conditions in the Americas
. (1990
). Washington, DC
: PAHO
.Palloni, A., & Millman, S. (
1986
). Effects of Inter-Birth Intervals and Breastfeeding on Infant and Early Childhood Mortality
. Population Studies
, 40
, 215
–36
. 10.1080/0032472031000142036Pebley, A.R., & Stupp, P.W. (
1987
). Reproductive Patterns and Child Mortality in Guatemala
. Demography
, 24
, 43
–60
. 10.2307/2061507Rios-Neto, E.L.G, McCracken, S.D., & Rodrigues, R.N. (
1991
). Contraceptive Use and Fertility in Brazil
Proceedings of the Demographic and Health Surveys World Conference
(pp. 113
–34
). Columbia, MD
: Macro International
.Rodrigues, R.N. 1992. “Levels and Differentials in Mortality by Diarrhea in Brazil.” Presented at the annual meetings of the Population Association of America, Denver.
Rodriguez, G. (
1994
). Statistical Issues in the Analysis of Reproductive Histories Using Hazard Models
. Annals of the New York Academy of Sciences
, 709
, 266
–79
. 10.1111/j.1749-6632.1994.tb30415.xRosenzweig, M.R., & Schultz, T.P. (
1982
). Child Mortality in Colombia: Individual and Community Effects
. Health Policy and Education
, 2
, 305
–48
. 10.1016/0165-2281(82)90015-7Rosenzweig, M.R., & Wolpin, K.I. (
1986
). Evaluating the Effects of Optimally Distributed Public Programs: Child Health and Family Planning Interventions
. American Economic Review
, 76
, 470
–82
.Rutstein, S.O. (
1984
). Socioeconomic Differentials in Infant and Child Mortality
. Voorburg, The Netherlands
: ISI
.Sastry, N. 1995a. “A Multilevel Hazards Model for Hierarchically Clustered Data: Model Estimation and an Application to the Study of Child Survival in Northeast Brazil.” Working Paper DRU-1101-RC, RAND Labor and Population Program.
Sastry, N. 1995b. “Community Characteristics, Individual Attributes and Child Mortality in Brazil: A Multilevel Hazard Model Analysis.” Doctoral dissertation, Princeton University.
Sastry, N., Goldman, N., & Moreno, L. (
1993
). The Relationship Between Place of Residence and Child Survival in Brazil
International Population Conference. Montreal 1993
(pp. 293
–322
). Liège
: IUSSP
.Sawyer, D.O., Fernández-Castilla, R., & Monte-Mor, R.M. (
1987
). The Impact of Urbanization and Industrialization on Mortality in Brazil
. World Health Statistics Quarterly
, 40
, 84
–95
.Sawyer, D.O., & Soares, E.S. (
1983
). Child Mortality in Different Contexts in Brazil: Variation in the Effects of Socio-Economic Variables
Infant and Child Mortality in the Third World
(pp. 145
–60
). Paris
: WHO
.Schorling, J.B., Wanke, C.A., Schorling, S.K., McAuliffe, J.E., de Souza, M. A., & Guerrant, R.L. (
1990
). A Prospective Study of Persistent Diarrhea among Children in an Urban Brazilian Slum
. American Journal of Epidemiology
, 132
, 144
–56
.Simões, C.C. (
1989
). Novas Estimativas da Mortalidade Infantil: 1980–87
Perfil Estatístico de Crianças e Mães no Brasil: Mortalidade Infantil e Saúde na Década de 80
(pp. 61
–78
). Rio de Janeiro
: IBGE
.Simoes, C.C., & de Oliveira, L.A.P. (
1986
). Evolução da Mortalidade Infantil
Perfil Estatístico de Crianças e Mães no Brasil: Aspectos Socio-Economicos da Mortalidade Infantil em Areas Urbanas
(pp. 431
–59
). Rio de Janeiro
: IBGE
.Spangler, W.M.L. and R.L. Jenne. 1988. “World Monthly Surface Station Climatology.” Mimeographed document, National Center for Atmospheric Research.
Strauss, J. (
1990
). Households, Communities, and Preschool Children’s Nutrition Outcomes: Evidence from Rural Côte d’Ivoire
. Economic Development and Cultural Change
, 38
, 231
–62
. 10.1086/451791Thomas, D., & Strauss, J. (
1992
). Prices, Infrastructure, Household Characteristics and Child Height
. Journal of Development Economics
, 39
, 301
–31
. 10.1016/0304-3878(92)90042-8Thomas, D., Strauss, J., & Henriques, M-H. (
1990
). Child Survival, Height for Age and Household Characteristics in Brazil
. Journal of Development Economics
, 33
, 197
–234
. 10.1016/0304-3878(90)90022-4Thomas, D., Strauss, J., & Henriques, M-H. (
1991
). How Does Mother’s Education Affect Child Height?
. Journal of Human Resources
, 26
, 183
–211
. 10.2307/145920Age Structure of Mortality in Developing Countries
. (1986
). New York
: United Nations
.Vaupel, J.W., Manton, K.G., & Stallard, E. (
1987
). The Impact of Heterogeneity in Individual Frailty on the Dynamics of Mortality
. Demography
, 16
, 439
–54
. 10.2307/2061224Victora, C.G., Smith, P.G., & Vaughan, J.P. (
1986
). Social and Environmental Influences on Child Mortality in Brazil: Logistic Regression Analysis from Census Files
. Journal of Biosocial Science
, 18
, 87
–101
. 10.1017/S0021932000006520Victora, C.G., Smith, P.G., Vaughan, J.P., Nobre, L.C., Lombardi, C., Teixeira, A.M.B., Fuchs, S.C., Moreira, L.B., Gigante, L.P., & Barros, F.C. (
1988
). Water Supply, Sanitation and Housing in Relation to the Risk of Infant Mortality and Diarrhoea
. International Journal of Epidemiology
, 17
, 651
–54
. 10.1093/ije/17.3.651Waldron, I. (
1987
). Patterns and Causes of Excess Female Mortality among Children in Developing Countries
. World Health Statistics Report
, 40
, 194
–210
.Ware, H. 1984. “Effects of Maternal Education, Women’s Roles, and Child Care on Child Mortality.” Pp. 191-214 in Child Survival: Strategies for Research, edited by W.H. Mosley and L.C. Chen. Supplement to Population and Development Review 10.
Wood, C.H., & Carvalho, J.A.M. (
1988
). The Demography of Inequality in Brazil
. New York
: Cambridge University Press
.Wood, C.H., & Lovell, P.A. (
1992
). Racial Inequality and Child Mortality in Brazil
. Social Forces
, 70
, 703
–24
. 10.2307/2579750Brazil: Economic Stabilization with Structural Reforms
. (1991
). Washington, DC
: World Bank
.© Population Association of America 1996
1996