Trends in socioeconomic inequalities in the health of newborns in the Czech Republic between 1990 and 2007

Martina Štípková, Charles University, Prague
Martin Kreidl, University of West Bohemia

Many post-socialist states witnessed a major health and mortality crisis as a result of profound economic and social changes caused by the collapse of state socialism. This was not the case of the Czech Republic, however: crude rates of perinatal as well as infant mortality were steadily improving after 1989. This positive trend might not, however, have affected all newborns in the same way since many newly appearing socioeconomic risks were significantly stratified. Hence, we explore trends in the socioeconomic disparities in the health of newborns. We use vital statistics data on all live singleton births that occurred in the Czech Republic in the years 1990, 1992, 1994, 1996, 1998, 2000, 2002, 2004 and 2007 (N=909 800). We use three different measures of child health based on birth weight: birth weight measured in grams, a binary indicator of low birth weight (i.e. below 2500 g), and a binary indicator of high birth weight (i.e. over 3500g). We estimate random-intercept multilevel models with maternal education as the main micro-predictor. Results show that the most overt disparity is between infants born to women with basic and any higher level of education. Educational disparities in birth weight measured in grams and in the odds of high birth weight rose during the study period, mainly in the 1990s, and currently seem to be stabilizing on a higher level. On the other hand, educational disparities in the risk of having a low birth weight baby were stable in the 1990s and then decreased. In conclusion, the influence of maternal education on the odds of having a baby with advantageous birth weight strengthened during the post-socialist transformation, but educational gap in the risk of adverse birth outcome (low birth weight) did not increase.