1. INTRODUCTION
PURPOSE
DISCUSSION
*
.
· Women of low socioeconomic status in the U.S. are at an increased risk of infant
mortality unlike countries such as Japan, France, Germany, and Italy
· Differences explained by how countries implement social and economic policies to
alleviate the effects of income inequality on health
· By enacting these policies, income inequality is not significantly contributing to infant
mortality rate (Hu, Lenthe, and Mackenbach 2015)
Change the Role of Providers
· Providers taking special care of mothers with high stress levels
Promote Economic Development in Low-Income Areas
· Programs to assist at-risk mothers not limited to health care coverage
Guarantee Paid Maternity Leave
· Guarantees an income during pregnancy leave
Enact Universal Health Care
· Guarantees citizens access to health care
METHODS
FINDINGS AND INTERVENTIONS RECOMMENDATIONS
Infant Mortality as a Marker for Health: Improving Rates within
the United States
Aditi Mankodi, Diana Tran, Olivia Harrington, and Timothy Glavin
Limitations
· Comparative countries differences in racial/ethnic diversity
· Comparative countries differences in population size
· Underreporting of live births by WHO definition
Strengths
· Programs at individual, community, or policy level
· Address social gradient of health
· Promotes maternal and infant health
· Promotes improving health and health outcomes
Conclusion
· The U.S. should model interventions to reduce the impact socioeconomic
status has on health outcomes to prevent increased risk of infant mortality
caused by social conditions.
Problem of Interest
· Infant mortality rate is a key indicator for population health and quality of
life, defined as the death of an infant before they reach their first birthday
(Pampel and Pillai 1986)
Burden of Problem
· The United States ranks low for an industrialized country
· Implication of social development and health, social, and economic outcomes
Risk Factors
· Health behavior
· Social and environmental conditions
· Socioeconomic status
· Race and ethnicity
· Social and economic policies
(Kim and Saada 2013)
Protective Factors
· Medical care
· Health care
· Living above the poverty line
· Compare the U.S. infant mortality rate with similarly developed
countries
· Look at whether socioeconomic status is a factor increasing infant
mortality rates
· Research if the social gradient of health exists in similarly developed
countries
· Conduct a policy-analysis to identify alternative policies the U.S. could
adopt
· Make policy recommendations aimed at decreasing infant mortality rates
Databases
· PubMed
· Google Scholar
· Centers for Disease Control and Prevention (CDC)
· World Health Organization (WHO)
Search Terms
· “Infant mortality and socioeconomic status”
· “Infant mortality United States”
· “Infant mortality rankings”
· “Infant mortality health policy”
Inclusion Criteria
· Compares infant mortality across the U.S. and world
· Looks at socioeconomic status in relation to infant mortality
· Public policies in developed countries
· Studies on specific developed countries: Germany, Italy, France, and
Japan
· Human data studies
· English language
References
Aspe.hhs.gov. 2015 Poverty Guidelines. 2015
Aspph.org. ASPPH | Columbia’s National Center for Children in Poverty Says State Safety Nets Offer Uneven Support to Low-income Working Families. 2015.
Cdc.gov. Infant Mortality Rates: Socioeconomic Status, United States. 2014
Cdc.gov. Poverty and Infant Mortality -- United States. 1988.
Cdc.gov. Recent Trends in Infant Mortality in the United States. 2015.
Field, D., Boyle, E., Draper E., Evans, A., Johnson S., … Smith L. “Towards Reducing Variations in Infant Mortality and Morbidity; a Population-based Approach.” Programme Grants for Applied Research. 2016).
Finch, Brian K. “Early Origins of the Gradient: The Relationship between Socioeconomic Status and Infant Mortality in the United States.” Demography 40(4) 675-699. (2003).
Hu, Yannan, Lenthe, Frank J., and Mackenbach, Johan P. “Income Inequality, Life Expectancy, and Cause-Specific Mortality in 43 European Countries, 1987-2008: A Fixed Effects Study.” European Journal of
Epidemiology. 30(8) 615-625. (2015).
International Health Statistics: What the Numbers Mean for the United States. Washington, D.C.: Office of Technology Assessment, U.S. Congress, 1993.
Kim, Daniel, and Adrianna Saada. "The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review." International Journal of Environmental Research
and Public Health IJERPH 10(6) 2296-335. (2013).
Lorch, S. A., Enlow E. “The Role of Social Determinants in Explaining Racial/Ethnic disparities in Perinatal Outcomes.” Pediatric Research. 79. 141-147. (2015).
Materia, Enrico. “Income inequality and Mortality in Italy.” European Journal of Public Health. 15(4). 411-417. (2015).
Pampel, Fred C., and Vijayan K. Pillai. "Patterns and Determinants of Infant Mortality in Developed Nations, 1950- 1975." Demography 23(4). 525. (1986).
Rodwin, V. G., & Neuberg, L. G. Infant Mortality and Income in 4 World Cities: New York, London, Paris, and Tokyo. Am J Public Health American Journal of Public Health, 95(1), 86-90. (2005).
Rossin, Maya. “The Effects of Maternity Leave on Children’s Birth and Infant Health Outcomes in the United States.” J Health Econ. 30(2): 221-239. (2011).
Recommendations and Overview
Increased Maternity Leave; Paid
· Promotes maternal health
· Reduces levels of stress during pregnancy
· Guarantees income
· More quality time with their infant
Enact Universal Health Care
· Guarantees health care access to all citizens
· Closes health care coverage gap
· Promote overall health
Implementation
· State and Federal government