Infant survival differentials in the city of toronto: a challenge to health planning and research.

Systems of health care that are not tailored to the differences that exist between people are wasteful inasmuch as genetic, cultural, social, political and other factors greatly affect not only health status and therefore health needs, but also utilization of health facilities. Fundamental to health planning, therefore, is knowledge of the health status as well as the demographic characteristics of the population for which plans are being made. Health status can be described subjectively or objectively.This paper deals with the objective description of differences existing in defined population groups in the City of Toronto in regard to infant survival. Fourteen percent of the population was identified as having mortality rates two to two-and-a-half times as high as 11 percent of the population with low rates. Demographic differences that exist between this 14 percent with high mortality rates as compared with the average for the remainder of the City of Toronto are described. The need for diversity in health planning, particularly for concentration of primary care facilities in these high risk areas through neighborhood health centres is implicit in these findings as is the need for organized health services research.