[Relationship between reproductive patterns and infant mortality: alternative interpretations]. / Relación entre patrones reproductivos y mortalidad infantil: interpretaciones alternativas.

A secondary analysis of the data of the Mexican National Fertility and Health Survey of 1987 (ENFES for its spanish acronym) was undertaken in order to study the relationship between reproductive patterns and child mortality. A total of 13,216 births and 711 infant deaths occurred 1 to 15 years previous to the survey were studied. The main conclusions are: 1) it is the adverse social, economic and environmental conditions surrounding young mothers (15 to 19 years) which are responsible for the excess mortality found in their children; 2) children of older women (35 and more years) experience increased mortality only in the late fetal period, this suggesting that a biological mechanism is mainly at stake; 3) the relative risks of death of first births, as compared to subsequent ones are generally smaller than one, indicating that first births have a lower probability of dying. The relative risk of death of first born relative to subsequent births, on the other hand, decreases with increasing age at death, suggesting that biological factors such as low birthweight and intrapartum complications are possibly important as well; 4) relative risks of death for short-spaced as compared to well spaced births were found, in general, to decrease from the late fetal to the neonatal and to the postneonatal periods. This points to a biological pathway, possibly via maternal nutrition, for the effect of spacing on child mortality.

[Limitations of infant mortality as a health indicator]. / Limitaciones de la mortalidad infantil como indicador de salud.

Infant mortality is usually accepted as a sensitive indicator of living conditions, and of the coverage and quality of health care in a specific country. However, the validity of this indicator in middle-income countries presents some important limitations. First, underegistration of infant deaths is a common feature. In second place, the national figures hide the great inequalities that may exist among different social sectors and regions. In this paper, the limitations of Mexico's infant mortality rate are analyzed. Underegistration is demonstrated by comparing infant mortality rates obtained from vital statistics data and national health surveys. Differences among social sectors are evident when specific infant mortality rates are compared. Inequalities have been increasing in the last years.

[A database for research in public health]. / Base de datos para la investigación en salud pública "BISP".

Epidemiological and health system research projects are often delayed due to the difficulties to build validated data basis in personal computers. This papers presents a new computer interactive program for handling numeric data from a given questionnaire to a structured archive. The questionnaire includes the basic variables of the dwelling and of the members of the household. A list of sociodemographic and health variables are selected, although other variables can be easily added, according to special needs. All the intermediate steps regularly needed to construct a data base are included in the package: capture, verification, validation and record linkage. The package is equipped with the basic procedures needed to produce tabulations and basic statistical analysis.

[Health measurement: theoretical and methodologic perspectives]. / La medición de salud: perspectivas teóricas y metodológicas.

The present article consists of a revision of the different ways health has been measured and was ordered according to the historic evolution of the health concept and conditions. The development of health measures has paralleled the changes occurred in the epidemiologic profiles and the many refinements in the conceptualization and interpretation of health. Along the years, the meaning of health has become increasingly wider. Initially, only infectious diseases were considered; later, degenerative processes were included. Nowadays, health is viewed as multifactorial and as a reflection of the life style and conditions. This essay contains a description of the theoretical postulates upon which the different health measures are based, their strategies and some of their limitations. It is divided into five main sections: morbidity, disability, and mortality indicators; measures of the health of the populations; sociomedical indicators, including measures of physical and mental health, as well as of the social component of health, positive health indicators and, finally a revision of measures of health need. It is of the utmost importance to be aware of the perspective used in the different public health research efforts since it has direct repercussions for the planning and evaluation of the health services and, in particular, for the quality of health care.