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Int J Epidemiol. 2014 Jun;43(3):818-26. doi: 10.1093/ije/dyt252. Epub 2013 Dec 30.

US infant mortality and the President's party.

Author information

1
Population Studies Center, Institute for Social Research, Department of Economics and Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
2
Population Studies Center, Institute for Social Research, Department of Economics and Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USAPopulation Studies Center, Institute for Social Research, Department of Economics and Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
3
Population Studies Center, Institute for Social Research, Department of Economics and Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USAPopulation Studies Center, Institute for Social Research, Department of Economics and Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA arline@umich.edu.

Abstract

BACKGROUND:

Infant mortality rates in the US exceed those in all other developed countries and in many less developed countries, suggesting political factors may contribute.

METHODS:

Annual time series on overall, White and Black infant mortality rates in the US were analysed over the 1965-2010 time period to ascertain whether infant mortality rates varied across presidential administrations. Data were de-trended using cubic splines and analysed using both graphical and time series regression methods.

RESULTS:

Across all nine presidential administrations, infant mortality rates were below trend when the President was a Democrat and above trend when the President was a Republican. This was true for overall, neonatal and postneonatal mortality. Regression estimates show that, relative to trend, Republican administrations were characterized by infant mortality rates that were, on average, 3% higher than Democratic administrations. In proportional terms, effect size is similar for US Whites and Blacks. US Black rates are more than twice as high as White, implying substantially larger absolute effects for Blacks.

CONCLUSIONS:

We found a robust, quantitatively important association between net of trend US infant mortality rates and the party affiliation of the president. There may be overlooked ways by which macro-dynamics of policy impact microdynamics of physiology, suggesting the political system is a component of the underlying mechanism generating health inequality in the USA.

KEYWORDS:

Infant mortality; health inequality; political parties; racial disparities

PMID:
24381011
PMCID:
PMC4052132
DOI:
10.1093/ije/dyt252
[Indexed for MEDLINE]
Free PMC Article
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