How socioeconomic status affects birth and death rates in rural Kerala, India: results of a health study.

Data relating to birth and death were collected from throughout the state of Kerala, India, in a health survey conducted by the Kerala Sastra Sahitya Parishad, a voluntary organization. In this study, the authors analyze birth and death rates as calculated from the sample of 9,940 households (57,665 persons), with respect to other variables such as region, religion, and socioeconomic status. In order to study the effect of socioeconomic factors on birth and death rates, a socioeconomic status rating (SES rating) was developed, taking into account such factors as income, education, housing conditions, and land ownership. Socioeconomic status was found to have a definite influence on birth and death rates, with higher socioeconomic status resulting in lower birth and death rates. This effect was independent of such confounding variables as age structure of the population, religion, and region. The higher risk of mortality among the poorer households can partly be explained by the material deprivation: the higher birth rates could be the result of poorer educational attainments.