Impact of international economic inequality and health care on global infant mortality

Infant mortality across the world has traditionally been assumed to reflect broad patterns of economic and social development. It has been taken as a central measure of human development. The purpose of this study was to determine whether this continues to be true in the early 21st century. The primary issue is whether income and wealth per capita (gross domestic product in international dollars) and health care expenditures are the primary influences on world infant mortality rates. Industrialized and developing countries were examined holding constant principal risk factors, birth rates, sanitation, other economic indicators, and education levels. International data are extracted from World Health Organization, World Bank and International Labor Organization sources. Using multivariable (regression) analysis, for the world sample of 137 countries, birth rates were the dominant factor associated with high infant mortality rates whereas GDP per capita, GDP in service industries and access to sanitation were the main sources of lower infant mortality rates. In industrialized countries (populations = 60) GDP per capita and GDP in services were the main sources of improved infant mortality. Employment in agriculture increased infant mortality, whereas access to sanitation and public health expenditures lowered mortality rates. In developing countries (populations = 50) GDP per capita showed no beneficial impact on infant mortality. The primary beneficial impact was from GDP in services, high calorie consumption from vegetables, a high literacy rate, and a minimal influence of health care expenditures. Extremely damaging to infant mortality were the birth rate, HIV prevalence, and cigarette consumption.