Socioeconomic inequalities in perinatal and infant mortality from 1854 to 1990 in Amsterdam, the Netherlands

Trends in socioeconomic differences in infant and perinatalmortality in Amsterdam were studied for the period 1854–1990,using published and unpublished material, at the aggregate andat the individual level. Absolute and relative socioeconomicmortality differences (SEMD) per data-set were calculated usinginequality indices developed by Pamuk. The results show a decreaseof the absolute differences in both infant and perinatal mortality.For infant mortality, this is mainly due to the overall declineof the infant mortality rate. Relative differences in infantmortality did not decrease during the study period. This isthe result of separate developments in 3 time periods. Fromapproximately 1850 to approximately 1910 an increase in relativedifferences can be seen, a trend which is reversed from approximately1910 to the end of World War II. After World War II relativedifferences seem to stabilize at the same level. For perinatalmortality, for which only data from the post-World War II periodare available, the decrease in the absolute differences is dueboth to the overall decline of the perinatal mortality rateand to a decline of relative differences between socioeconomicgroups. It is conduded that although SEMD in infant and perinatalmortality have declined in an absolute sense, they still existand that the relative position of deprived groups concerninginfant mortality was not ameliorated during the study period.