Infant death rates are an established and reliable index of general public health progress in industrial societies. As so often happens this means of evaluation has come to be accepted as a principle applicable to all regions, with failure to recognize that high mortality rates in developing regions is not restricted to infancy. They continue through early childhood. At ages 1 through 4 years, deaths approximate one half of those in the first or infant year; sometimes they are of equal number, and occasionally they are more. In industrial countries the proportion is about 15%.
The singular significance in developing countries of death rates in the second year is largely unappreciated, masked as it is by the common demographic practice of viewing the four years after infancy as a group.1 Deaths during the second year commonly account for one half of fatalities during that time, and sometimes, for three
THE SECOND CHILDHOOD YEAR. JAMA. 1968;203(7):514–515. doi:10.1001/jama.1968.03140070070017
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