UBC Theses and Dissertations
Indian infant mortality in British Columbia Baker-Anderson, Marilyn
Although the Indian infant mortality rate has dropped from 66 deaths per 1000 live births in 1960 to 24.6 deaths per 1000 live births in 1980, considerable discrepancies continue to exist between the Indian and Non-Indian population in British Columbia. The high incidence of Indian infant mortality is an important issue to B.C.'s native population. While governments have instituted programs in an effort to improve the health status of Indian infants, no studies have been undertaken in British Columbia to identify those factors which influence Indian infant mortality. This study examines the theoretical and empirical relationship between Indian infant mortality and a variety of socio-economic and health care factors. Using data derived from matched birth and death certificates and information acquired from the Department of Indian Affairs, this study assesses the effects of the following variables on neonatal and post neonatal mortality: 1. Maternal Age/Live Birth Order, 2. Marital Status, 3. Place of Delivery, 4. Region, 5. Welfare Dependency, and 6. Health Jurisdiction. Tests of partial and marginal association were performed initially to identify those variables which were not significantly related to the Birth Outcome. As the results of these tests revealed that Place of Delivery was the only significant variable, various regression models were constructed to estimate the effects of non-hospitalization and hospitalization on neonatal and postneonatal mortality. The findings a from these tests indicated that when non-significant factors were eliminated from the regression model, the variable, Place of Delivery, was not significantly related to the Birth Outcome. Factors to account for these results were then discussed. In particular, consideration was given to the extent to which shortcomings in the data and study methodology may have affected the results of statistical tests. To develop a better understanding about the nature of Indian infant mortality, the major causes of Indian infant deaths were examined over various historical periods. After reviewing changes in the distribution of deaths this study described, theoretically, how changes in the social and economic structure in Indian communities affected Indian health and more specifically Indian infant health. It was argued that while life style factors and certain aspects of the physical environment may affect infant mortality, these factors should not be viewed in isolation. Changes in Indian economic and social systems have had direct and indirect consequences on the physical and mental health of native people. To the extent that these changes are on-going they still may have some bearing on Indian infant health problems today. Based on this theoretical perspective this study examined the adequacy of past and present health programs and described some of the limitations of government intervention strategies. The concluding section argues that self-help preventive programs and medical/technical solutions are of limited utility in terms of reducing infant morbidity and mortality. Furthermore, while it may be possible to improve the standard of living of Indian people through transfer payments or other social welfare schemes, these strategies may provide only partial solutions if broader social problems are direct and indirect causal factors of ill-health. To the extent that social problems may be related to certain aspects of their psycho-social environment, it is essential that governments adopt strategies which provide the opportunities for Indians to regain self-respect and control over the institutions which affect their daily lives.