Kim, Tai Hun
Description
Historical mortality declines in developed areas of the world
resulted primarily from economic growth leading to improvements in
living standards, while the importation of modern medical technologies
has been largely responsible for the more recent mortality reductions
in the developing countries. Since the Korean mortality transition
began around 1900, it was, at first, comparable with the experience in
the developing countries, mainly resulting from a limited control of
some infectious...[Show more] diseases and reduction in incidence of major food
shortages, and later, since about 1960, it has continued, in the wake
of socioeconomic development. As a result, mortality has reached a
moderately low level: 61.3 years of expectation of life at birth for
males and 67.5 years for females in 1976-80.
The main objectives of the present study were to ascertain clearly
the present situation of Korean mortality and to investigate the
changing determinants of Korean mortality transition. Additionally, on
the basis of the Korean mortality transition, we have shown a general
pattern of changing determinants in mortality decline with the progress
of socioeconomic development. This study adopted death registration
data in the period 1970-81 for adult mortality and in 1980-81 for
cause-of-death analysis; and the 1974 Korean National Fertility Survey
data in the period 1955-73 for the study of infant and childhood (ages
1-4 years) mortality. While the age-specific death rates declined remarkably at all ages
between 1971-75 and 1976-80, the mortality trend of the late childhood
and young adult ages (5-34 years of age) stood out because of the
relatively large decline; the declines in female mortality were in all
age groups faster than those for males; as a consequence, the
difference in expectation of life at birth between males and females,
favouring females, widened from 5.0 years in 1971-75 to 6.8 in 1976-80.
The age-sex mortality pattern in Korea conformed to the 'Far Eastern
pattern', characterized by higher male death rates among the older than
expected on the basis of mortality levels at the younger ages in model
life tables, and very high sex ratios of death rates at the older ages.
The differentials in adult mortality by socioeconomic variables
were clear and in the expected direction: mortality levels among urban
residents, higher educated groups, and non-agricultural workers were
lower than among the other sub-groups. The net effects of each of the
four socioeconomic variables, which were place of residence,
educational level, marital status and occupation, on adult mortality
were statistically significant. Among them, educational level was the
most important factor for the determination of the adult mortality
level; the differences in mortality by occupation were brought out
mainly by the difference in educational level among occupational
categories.
In both urban and rural areas, in Korea, mother's education is the
most important determinant of infant mortality; on the other hand,
maternal age and number of rooms used are the main determinants of
child mortality. Previous birth interval and previous birth's survival
also significantly affect infant mortality; previous birth interval
affects child mortality, in both urban and rural areas. In general, demographic factors are relatively more important for infant mortality
in rural areas and for child mortality in urban areas; in contrast,
socioeconomic factors are dominant determinants of infant mortality in
urban areas and of child mortality in rural areas.
The mortality transition accompanied by socioeconomic development
in Korea changed the pattern of mortality differentials between urban
and rural areas: the mortality differences between the two areas
widened until the late 1970s and then narrowed gradually. Also, the
increasing proportion of the population with higher education,
especially in the younger age groups, has pressed down the mortality
level in the 9-year period between 1970-72 and 1979-81.
On the basis of the analysis of Korean data, the changing patterns
of demographic and socioeconomic determinants of infant and child
mortality are generalized. The pattern for infant mortality is: (I) in
a traditional society demographic factors affect infant mortality more
than socioeconomic factors; (II) at the early stage of development,
demographic factors are replaced by socioeconomic factors as the main
determinants of infant mortality; (III) when the difference in living
standards between social classes narrows, the socioeconomic
differentials in mortality also diminish; and (IV) at the stage of high
development the effects of demographic factors (endogenous causes) are
left although the absolute differences are very small. The pattern of
changing determinants of child mortality is nearly the reverse of that
of infant mortality.
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