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Figure 4. Health Depressed Neighborhoods of Washington, D.C., 1960

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COMMENT

The poverty area designation was developed by the Census Bureau to improve statistical information concerning poverty in the United States in the SMSA's with a population of 250,000 or more. Using 1960 census data, the identification of such areas permits classification of households by their neighborhood characteristics. It is thus possible for the first time to compare characteristics of families living in areas of major concentrations of poverty with those living in other portions of large metropolitan areas of the United States. (1) As illustrated in the case of Chicago and the District of Columbia, grouping of vital events such as births and deaths according to poverty and nonpoverty areas or neighborhoods, results in a marked differentiation of various health indices. Thus, neighborhood rates help to identify geographically the areas where health and related problems are particularly concentrated. Furthermore, the poverty areas, because of the national definition, are comparable among the SMA's; that is, for each area the census tracts were graded on the same five variables, and the resulting composite weights were arrayed to identify the fourth or poorest quartile.

Movement of families from one residence to another since 1960 has doubtless altered the composition of neighborhoods in respect to individual families in poverty areas. However, characteristics of the newcomers may not be very different from those who left poverty areas since 1960. Pending revision of the areas following the 1970 census, local studies can appraise the current relevance of the poverty areas based on 1960 data. The sample survey conducted by the Bureau of the Census in March 1966 of families residing in poverty areas showed a continuing concentration of nonwhite families. As pointed out in the survey, other subgroups of the population proportionately overrepresented in poverty areas were families headed by a woman, families with large numbers of related children (five or more), and families headed by an unemployed person or by a semiskilled or unskilled worker. (1)

Identification of small areas with excessive risks to health and survival is a vital element in effective State and local planning and implementation of the maternity and infant care projects authorized by the 1963 amendments to the Social Security Act. These projects, which now number 53, make available necessary health care to mothers and their infants in low-income or otherwise deprived families who are exposed to unusual risks. Similarly, health indices for poverty areas, in comparison with other areas of the large SMSA's, will assist the States in extending by 1975 maternal and child health services throughout their jurisdictions, pursuant to the 1965 amendments.

If efforts to reduce the high infant death rates prevailing in many parts of the United States are to be successful—and at the earliest possible time--a more specific definition of target groups is essential. The attack on this critical national problem must then be joined by program planning which is responsive to the widely-varying needs of this target population.

REFERENCES

(1) Bureau of the Census, U.S. Department of Commerce, "Current Popula. tion Reports, Characteristics of Families Residing in Poverty Areas," March 1966. Technical Studies, Series P-23, No. 19, August 24, 1966.

(2) City of Chicago, Board of Health. (communication).

(3) Hunt, Eleanor P. and Earl E. Huyck. "Mortality of White and Nonwhite Infants in Major U.S. Cities,” Indicators, January, 1966, U.S. Department of Health, Education, and Welfare.

(4) Lesser, A. J., C. P. Gershenson, E. P. Hunt, R. R. Bonato, and M. W. Pratt. “Infant and Perinatal Mortality Rates by Age and Color: United States, Each State and County, 1951-1955, 1956–1960." Children's Bureau and Maternal and Infant Health Computer Project, Washington, D.C., 1967.

(5) National Center for Health Statistics, National Vital Statistics Division, United State Department of Health, Education, and Welfare, Public Health Service, Vital Statistics of the United States 1964, Volume I, Natality, Section 2: and Volume II, Part B, Mortality, Section 7. U.S. Government Printing Office, 1966.

(6) National Center for Health Statistics, National Vital Statistics Division, U.S. Department of Health, Education, and Welfare, Public Health Service, Vital Statistics of the United States 1965, Volume I, Natality, and Volume II, Part B, Mortality (to be published).

30–266–69—pt. 7-53

(7) Office of Business Economics, U.S. Department of Commerce, Survey of Current Business, August 1966.

(8) Office of Economic Opportunity, “Maps of Major Concentrations of Porerty in Standard Metropolitan Statistical Areas of 250,000 or More Population," Office of Research, Plans, Programs and Evaluation, October 3, 1966.

(9) Okada, Louise M., and William F. Stewart. Health Indices and Poverty Areas, Statistical Notes, No. 2, December, 1966, Department of Public Health, District of Columbia.

(10) Pakter, Jean, Henry J. Rosner, Harold Jacobziner, and Frieda Greenstein. (a) “Out-of-Wedlock Births in New York City," Part I, Sociological Aspects, American Journal of Public Health, 1961, 51, 683-696 (May); (b) "Outof-Wedlock Births in New York City," Part II, Medical Aspects, American Journal of Public Health, 51, 846–865 (June).

INFANT MORTALITY RATE, UNITED STATES, EACH STATE AND SPECIFIED AREAS, 1955-67
INumber of deaths under 1 year per 1,000 live births by place of residence, exclusive of fetal deaths)

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INFANT MORTALITY RATE, UNITED STATES, EACH STATE AND SPECIFIED AREAS, 1955-67–Continued
[Number of deaths under 1 year per 1,000 live births by place of residence, exclusive of fetal deaths]

1958
1956
1957

1959 1960 1961

1962 1963 1964

State

1955

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Pennsylvania.
Puerto Rico 23.
Rhode Island.
South Carolina
South Dakota.
Tennessee
Texas.
Utah..
Vermont.
Virgin Islands 23
Virginia.
Washington.
West Virginia.
Wisconsin.
Wyoming.

24.6 55.8 23.4 34.1 26.1 29.2 30.3 20.4 26.1 44.9 29.5 24.5 27.3 23.7 28.5

24.5 55.1 24.2 32.2 23.3 27.5 29.5 21.8 24.1 66.5 29.6 23.4 25.2 22.8 27.8

24.5 50.3 24.1 31.6 26.0 29.2 29.5 21.6 25.4 50. 1 30.2 24. 2 27.4 22. 2 26.5

25.5 53.2 21.3 33.9 26.3 30.9 30.6 22.2 22.4 44.3 31. 1 26.1 26.4 23.6 27.8

24.9 47.6 24.0 35. O 22.9 30.3 28.5 20.0 23.7 43.4 31.0 24.0 27.2 23.4 26.9

24.5 43.3 23.3 34.3 28.1 29.4 28.9 19.6 24.1 35.6 29.8 23.4 25.5 21.8 28.2

23.6 41.5 22.5 32.4 25.1 29.2 26.7 20.3 27.2 42.7 28. O 22.7 26. 7 22.7 27.0

24.0 41.7 25.5 31.5 25.3 28.7 27.1 19.7 22.7 29.1 29.2 22.8 26.5 20.7 30.3

23.7 44.6 23.9 33.0 24.7 28.0 27.6 18.6 24.6 31.7 29.2 22.1 26.1 22.3 28.5

23.1 51.6 24.9 31.1 22.5 28.2 27.4 20.0 24.7 28.4 28.0 22.5 23.5 20.8 29.0

23.3 42.8 22.5 31.3 22.7 28. O 26.0 18.7 21.9 30.0 26.6 21.4 26.8 21.9 22.1

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1 Exclusive of Puerto Rico, Virgin Islands, and of Alaska, 1955–58, and Hawaii, 1955-59. 2 By place of occurrence, except Alaska, 1959-64; and Hawaii, 1960-64.

3 Data not available. Source of data: Public Health Service, National Center for Health Statistics.

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