Socioeconomic determinants of infant mortality: A worldwide study of 152 low-, middle-, and high-income countries

Schell, Carl Otto; Reilly, Marie; Rosling, Hans; Peterson, Stefan; Ekström, Anna Mia

doi:10.1080/14034940600979171

Cited by 199 publications

(166 citation statements)

References 32 publications

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“…It has also been found that the positive effect of national income on LEB is stronger for developing countries with higher levels of income. In the poorest countries of the world, instead of GDP, determinants of health including female illiteracy (Schell et al, 2007), public spending on health, ethnic fragmentation (Houweling et al, 2005), and global factors including advances in medical technology and diffusion of health technology (Asiedu et al, 2015) have strongest association with health. Furthermore, the relation is not so simple on closer inspection and likely to be affected by a complex and possibly non-monotonic relation between income per capita, health, population dynamics and other factors including education, quality of institutions, and many more; for a recent summary of the literature see Cervellati (2011) and Deaton (2006).…”

Section: Universal Health Carementioning

confidence: 99%

Priorities for action on the social determinants of health: Empirical evidence on the strongest associations with life expectancy in 54 low-income countries, 1990–2012

Hauck

Martin

Smith

2016

Social Science & Medicine

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The WHO Commission on the Social Determinants of Health set out an impressive collection of policy proposals on the social determinants of health. However, a serious weakness for securing implementation is the difficulty for policymakers in identifying priorities for action. The objective of this study is to determine a small set of the most influential determinants using existing data and an empirical approach. 45 Indicators from the World Bank's World Development Indicators are selected to measure attainment for the determinants proposed by the Commission. Panel data models of life expectancy at birth for 54 low-income countries over the years 1990 to 2012 are estimated. Each determinant is subjected to a robustness test using Extreme Bound Analysis, to determine the stability of its estimated impact on life expectancy. For 20 robust and significant determinants the magnitude of association with life expectancy is determined. The largest average increases in life expectancy at 14.5 months per capita is associated with a one standard deviation reduction in HIV prevalence among children, followed by advances in gender equality at 9.4 months. Improvements in life expectancy between 6 and 9 months are associated with agricultural production, political stability, access to clean water and sanitation, good governance, and primary school enrolment. Improvements below 6 months are associated with increases in private health expenditure and overseas development assistance, and control of armed conflict and HIV prevalence among men. There is no evidence that national income, public spending on healthcare and education, secondary schooling, terms of international trade, employment, debt service and relief, out-of-pocket expenditures, agricultural ex-or imports, lifestock production, foreign investment, urbanization or environmental degradation are robustly associated with population health. Results provide support for the relevance of some proposed policies. The findings can inform priorities for future research and policy action on the social determinants of health.

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Section: Universal Health Carementioning

confidence: 99%

Priorities for action on the social determinants of health: Empirical evidence on the strongest associations with life expectancy in 54 low-income countries, 1990–2012

Hauck

Martin

Smith

2016

Social Science & Medicine

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“…Low literacy is often linked to poor socio-economic circumstances, and in turn with adverse effects on health that are independent of other risk factors (Jahan 2008). This is especially the case in the relationship between female literacy and maternal and child health outcomes (Schell et al 2007). People with poor literacy tend to be less responsive to health education, less likely to use disease prevention services, and to successfully manage chronic disease (Dewalt et al 2004).…”

mentioning

confidence: 99%

Defining and measuring health literacy: what can we learn from literacy studies?

Nutbeam

2009

Int J Public Health

247

186

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“…Las relativamente grandes disparidades en Colombia potencian el problema acerca de la relativa importancia de las condiciones socioeconómicas frente a la atención en salud en la determinación de la TMI en todo el país; tal como se ha presentado en la literatura reciente (19) . Una hipótesis plausible es que a medida que las condiciones económicas mejoran y disminuyen las tasas de mortalidad infantil, la tecnología médica empieza a cobrar relativa importancia, puesto que los efectos de las condiciones socioeconómicas tienden a desvanecerse (desnutrición, baja adherencia al control prenatal y posnatal, etc.…”

Section: Discussionunclassified

Brechas regionales de la mortalidad infantil en Colombia.

Jaramillo-Mejía

Chernichovsky

Jiménez-Moleón

2014

Rev Peru Med Exp Salud Publica

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RESUMENObjetivos. Estudiar las variaciones de la tasa de mortalidad infantil (TMI) en los departamentos de Colombia durante el período [2003][2004][2005][2006][2007][2008][2009], examinar la persistencia de las variaciones entre los departamentos sobre el tiempo y relacionarlas con el impacto de las condiciones socioeconómicas y la disponibilidad de servicios de salud, sobre la mortalidad infantil. Materiales y métodos. Utilizando estadísticas vitales y relacionando datos socioeconómicos y de servicios de salud, se analizaron tres aspectos: la variación de la TMI departamental (2003)(2004)(2005)(2006)(2007)(2008)(2009), la relación entre la TMI departamental y determinantes claves en el tiempo, y las líneas de causalidad e impacto relativo de los diferentes factores. Se emplearan ecuaciones estructurales. Resultados. Se encontró una razón de 4,7 entre la mayor y menor TMI departamental (2009), esta podría estar subestimada principalmente por el subregistros en departamentos de bajos ingresos. Hay una relación negativa entre la TMI departamental con el tiempo y variables altamente correlacionadas, como educación de la madre, ingreso per cápita, cobertura de aseguramiento y acceso a servicios. Conclusiones. El efecto del aseguramiento, disponibilidad de camas privadas y atención médica, es superior al impacto de mejores condiciones socioeconómicas sobre la TMI. La oferta de servicios no parece estar influenciada por una política racional, los recursos no se asignan de acuerdo con las necesidades, sino con el desarrollo general. Las camas privadas se hacen disponibles donde hay mejor aseguramiento en salud y menor TMI. Palabras clave: Tasa de mortalidad infantil; Desigualdades en la salud; Factores socioeconómicos; Cobertura del seguro; Colombia (fuente: DeCS BIREME). REGIONAL DISPARITIES IN INFANT MORTALITY IN COLOMBIA ABSTRACTObjectives. To study the variations in infant mortality rate (IMR) across Colombia's 33 administrative departments over the period [2003][2004][2005][2006][2007][2008][2009], examine persistency of variations across departments over time, and relate those variations to the impact of socio-economic conditions and availability of care on IMR. Materials and methods. Using vital statistics and related socio-economic data we establish three types of analysis according to: (a) the variation of the departmental IMR (2003)(2004)(2005)(2006)(2007)(2008)(2009), (b) the association between the departmental IMR and its key determinants over time, and (c) the lines of causality and relative impact of different factors, by using structural equations. Results. The 4.7 fold ratio between the highest and lowest departmental IMR (2009) may be underestimated considering underreporting, especially in low-income departments. There is a negative association between the departmental IMR with time and a set of highly correlated variables, such as the mother education, income per capita, health insurance level and access to services. Conclusions. The effect of better insurance, availability of private beds, and havi...

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Socioeconomic determinants of infant mortality: A worldwide study of 152 low-, middle-, and high-income countries

Cited by 199 publications

References 32 publications

Priorities for action on the social determinants of health: Empirical evidence on the strongest associations with life expectancy in 54 low-income countries, 1990–2012

Priorities for action on the social determinants of health: Empirical evidence on the strongest associations with life expectancy in 54 low-income countries, 1990–2012

Defining and measuring health literacy: what can we learn from literacy studies?

Brechas regionales de la mortalidad infantil en Colombia.

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