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  • Title: Modelling determinants of health.
    Author: Patel M.
    Journal: Int J Epidemiol; 1981 Jun; 10(2):177-80. PubMed ID: 7287277.
    Abstract:
    The linear regression procedure of stepwise elimination has been used to examine the association between a range of environmental variables and infant mortality rates (IMR) in Sri Lanka. The nature of the water supply was found to be significantly associated with IMR. Latrines were significantly associated with IMR once qualitative differences between districts were allowed for. Other 'environmental determinants of health', 3 indices of housing quality and the presence of electricity supplies, were not significant. The cost of effecting changes in IMR by extending subsidies to water supply improvements is estimated. McKeown (1976) suggested that a large part of the historical improvements in the health of populations of the now developed nations took place in conjunction with socioeconomic improvements. The relevance of this to developing countries and its economic implications was explored with an analysis of infant mortality rates (IMR) in the 22 districts of Sri Lanka in relation to housing and basic utilities. The percentage of households in each district of Sri Lanka with basic utilities in the year of the National Census (1971) were correlated and regressed against the IMR/1000 live births for the same year. The utilities were tap water, well water, river water, latrines, cement floors, asbestos or tile roofs, brick or cabook walls, and electricity. A sequential regression analysis with stepwise elimination was used. The only variables significantly associated with the IMR appeared to be those concerning the nature of the water supply used by the households. Latrines were significantly associated with IMR once allowance was made for qualitative differences between districts. The cost of effecting changes in IMR by extending subsidies to water supply improvements is estimated.
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