Adult health and mortality among women in Matlab, Bangladesh: The effects of socioeconomic status, early life health, and reproductive behavior

Linda Irene Duffy, University of Pennsylvania


This dissertation includes three papers examining the relationship between health in early life, socioeconomic status (SES), and reproductive behavior and both adult health and survival among 2,441 women from Matlab, Bangladesh who participated in the Determinants of Natural Fertility Study (DNFS). The first chapter is a 20-year survival analysis from the mid-1970's through 1996. Survival varied significantly by SES attained early in life. There was no relation between survival and SES in adulthood. Uneducated women had a 204% and Hindus had an approximately 56% greater net chance of dying during the follow-up period compared to women with some education and Muslims respectively. Height had a significant relationship to mortality although the effects of stunting may be confounded by the fact that some sample members may not have completed their linear growth when height was measured. The second chapter considers the relationship between fertility and mortality, controlling for the socioeconomic and health effects found in the previous chapter. While some significant short-term effects of giving birth were found, no significant long-term effects of cumulative fertility were observed net of the influences of SES and health status at baseline. Women of reproductive age who gave birth in the index or previous two person-years had a 113% greater net chance of dying compared to women who did not. There was no relation between parity/the pace of fertility and mortality risks in the short-term. The third chapter examines the health of sample members interviewed approximately 20 years after the DNFS in the Matlab Health and Socioeconomic Survey (MHSS). Again, early life health and SES were significant predictors of BMI in the MHSS. Also, later life SES was related to BMI in the MHSS. Better-off women had higher BMI. Early life factors—health and SES—were significant predictors of declines in BMI, but current SES was not. Women who had higher SES early in life had less change in BMI, while the higher the BMI in the DNFS, the greater the likelihood of a decline. Only later life factors—BMI, income in the MHSS, and season—were related to self-assessed health.

Subject Area

Demographics|Womens studies|Public health

Recommended Citation

Duffy, Linda Irene, "Adult health and mortality among women in Matlab, Bangladesh: The effects of socioeconomic status, early life health, and reproductive behavior" (2000). Dissertations available from ProQuest. AAI9989585.