INFANT MORTALITY, ECONOMICS, AND ARMS

Abstract

To determine the impact of medical care on the infant mortality rate, it is necessary to control for socioeconomic factors which are more important. Infant mortality is a highly sensitive indicator of social and economic development. Among 42 countries with gross national product below $300/head, the infant mortality rate in 1970-75 ranged from 45/1000 to 208/1000 live births. Among 18 "Western" countries with GNP above $2000/head, the range was 11-30/1000. Examination of secular trends in developed countries lends support to the link between economic factors and infant mortality. In the US and Europe infant mortality has declined almost steadily while per capita wealth has, on the whole, been increasing. British data show that this improvement has affected all social classes. The downward trend in infant mortality has not been interrupted, and the work by Brenner seems to show that changes in infant mortality, and some other mortality statistics, correlate with changes in the general economic state of a country. Infant mortality increases about 1 year after, and proportional to, an economic downturn. On the basis of these findings Brenner concludes that the downward trend in mortality has not gone so far that substantial further improvement will come about only through advances in basic medical knowledge. His evidence taken in conjuction with cross-sectional data and secular social class patterns makes a fairly convincing case for a causal inverse link between affluence and infant mortality in Western nations. The exact nature of this link is hard to grasp. Brenner's work supports the view that either consistent decreases or small temporary increases will follow from economic trends over which there is little control. A persistent increase would be disturbing, and this seems to have already occurred in the Soviet Union. The infant mortality rate increased from 23/1000 to 31/1000. The gross national product of the Soviet Union is said to be less than half that of the US, yet it is putting resources into military expenditure that even the US has trouble matching. The arms race is continuing, and Western economies may not be growing at a sufficient rate to sustain it without cuts in public expenditure. A sad speculation is that in the near future a statistician may report that in the underdeveloped world infant mortality is negatively correlated with the purity of the water supply, whereas in developed nations it is positively correlated with the proportion of per capita income expended on arms.