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J Public Health Policy. 2015 Aug;36(3):287-303. doi: 10.1057/jphp.2015.12. Epub 2015 May 14.

Why history matters for quantitative target setting: Long-term trends in socioeconomic and racial/ethnic inequities in US infant death rates (1960-2010).

Author information

1
Department of Social and Behavioral Sciences (SBS), Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Kresge 717, Boston, MA 02115, USA.
2
Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
3
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
4
Department of Sociology, Harvard University, William James Hall, 6th Floor, 33 Kirkland Street, Cambridge, MA 02130, USA.
5
Program on Global Health and Human Rights, Institute for Global Health, Keck School of Medicine, Gould School of Law, University of Southern California, 2001 Soto Street, Floor 3, Los Angeles, CA 90032, USA.

Abstract

Policy-oriented population health targets, such as the Millennium Development Goals and national targets to address health inequities, are typically based on trends of a decade or less. To test whether expanded timeframes might be more apt, we analyzed 50-year trends in US infant death rates (1960-2010) jointly by income and race/ethnicity. The largest annual per cent changes in the infant death rate (between -4 and -10 per cent), for all racial/ethnic groups, in the lowest income quintile occurred between the mid-1960s and early 1980s, and in the second lowest income quintile between the mid-1960s and 1973. Since the 1990s, these numbers have hovered, in all groups, between -1 and -3 per cent. Hence, to look back only 15 years (in 2014, to 1999) would ignore gains achieved prior to the onset of neoliberal policies after 1980. Target setting should be informed by a deeper and longer-term appraisal of what is possible to achieve.

PMID:
25971237
PMCID:
PMC4711344
DOI:
10.1057/jphp.2015.12
[Indexed for MEDLINE]
Free PMC Article

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