J. biosoc. Sci. (1989) 21, 357-364 MALNUTRITION AND CHILD MORTALITY: ARE SOCIOECONOMIC FACTORS IMPORTANT? ABBAS BHUIYA*, BOGDAN WOJTYNIAKt AND REZAUL KARIMJ International Centre for Diarrhoea! Disease Research, Dhaka, Bangladesh Summary. The influences of household economic condition, maternal education, sex, and nutritional status of children on mortality were examined using multivariate analytical techniques. Weights of around 1700 children aged 2-60 months in five villages of Matlab, Bangladesh, were taken during the first half of 1981. The children were followed for 18 months and their survival was recorded. The severely malnourished children had a risk of death nine times that of their counterparts with better nutritional status. Female children had a higher risk of death than the males. Mother's education and economic condition of household also showed negative relationships with the risk of death, but the effect of mother's education was modified by economic condition and sex of the children. Introduction The relationship between socioeconomic variables and child mortality in the developing countries (Caldwell, 1979; D'Souza & Chen, 1980; D'Souza & Bhuiya, 1982; Martin et al, 1983; Trussell & Hammerslough, 1983; DaVanzo, 1984; Tekce & Shorter, 1984) has attracted much attention in recent years (Mosley & Chen, 1984; Bhuiya, Zimicki & D'Souza, 1986b; Ruzicka & Kane, 1986). Undernutrition, resulting mainly from infection and inadequate food intake (Chen & Scrimshaw, 1983; Mata et al., 1977), was found to be a good predictor of death (Sommer & Lowenstein, 1975; Keilmann & McCord, 1978; Chen, Chowdhury & Huffman, 1980; Trowbridge & Sommer, 1981; Briend, Wojtyniak & Rowland, 1987) and inversely correlated with socioeconomic variables (Desai, Standard & Miall, 1970; Valverde et al., 1980; Bairagi, 1982; Bhuiya et al., 1986a,b). Consequently, nutritional status has been considered as an intermediate variable through which socioeconomic factors operate to affect mortality. However, the existence of the other pathway, socioeconomic status-morbidity-mortality, bypassing nutritional status, may not be ignored. In cases of acute disease the outcome may rapidly be fatal if proper actions are not initiated by the household members. The initiation of the actions as well as Present address: * Department of Demography, Australian National University, Canberra. t Department of Medical Statistics, National Institute of Hygiene, Warsaw. J Department of Biostatistics, Johns Hopkins University, Baltimore, USA. 357