Next Article in Journal
Indoor Air Quality in Urban and Rural Preschools in Upper Silesia, Poland: Particulate Matter and Carbon Dioxide
Previous Article in Journal
Secondary Particulate Matter Originating from an Industrial Source and Its Impact on Population Health
Article Menu

Export Article

Open AccessArticle
Int. J. Environ. Res. Public Health 2015, 12(7), 7682-7696; doi:10.3390/ijerph120707682

Levels of Urbanization and Parental Education in Relation to the Mortality Risk of Young Children

1
School of Preclinical Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
2
The Sun Vitality Clinic, Taichung 43748, Taiwan
3
Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 10845, Taiwan
4
Department of Public Health, College of Public Health, China Medical University, Taichung 40454, Taiwan
5
Department and Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
6
Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
7
School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
8
Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 11031, Taiwan
9
Center for Evidence-Based Medicine, Taipei Medical University, Taipei 11031, Taiwan
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 20 May 2015 / Revised: 23 June 2015 / Accepted: 1 July 2015 / Published: 8 July 2015
View Full-Text   |   Download PDF [695 KB, uploaded 8 July 2015]

Abstract

Background: The establishment of the National Health Insurance program in Taiwan in 1995 effectively removed the financial barrier to access health care services of Taiwanese people. This population-based cohort study aimed to determine the independent and joint effects of parental education and area urbanization on the mortality risk among children under the universal health insurance coverage in Taiwan since 1995. Methods: We linked 1,501,620 births from 1996 to 2000 to the Taiwan Death Registry to estimate the neonatal, infant, and under-five mortality rates, according to the levels of parental education and urbanization of residential areas. We used a logistic regression model that considers data clustering to estimate the independent and joint effects. Results: Lower levels of parental education and area urbanization exerted an independent effect of mortality on young children, with a stronger magnitude noted for areas with lower levels of urbanization. Children whose parents had lower levels of education and who were born in areas with lower levels of urbanization experienced the highest risk for neonatal (odds ratio (OR) = 1.60, 95% CI = 1.46–1.76), infant (OR = 1.58, 95% CI = 1.48–1.70), and under-five (OR = 1.71, 95% CI = 1.61–1.82) mortality. Conclusions: Even with universal health insurance coverage, lower levels of area urbanization and parental education still exerted independent and joint effects on mortality in young children. This finding implies the inadequate accessibility to health care resources for children from socially disadvantaged families and less urbanized areas. View Full-Text
Keywords: neonatal mortality; infant mortality; under-five mortality; socioeconomic status; cohort studies neonatal mortality; infant mortality; under-five mortality; socioeconomic status; cohort studies
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Fang, H.-S.; Chen, W.-L.; Chen, C.-Y.; Jia, C.-H.; Li, C.-Y.; Hou, W.-H. Levels of Urbanization and Parental Education in Relation to the Mortality Risk of Young Children. Int. J. Environ. Res. Public Health 2015, 12, 7682-7696.

Show more citation formats Show less citations formats

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top