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Inequality as a Powerful Predictor of Infant and Maternal Mortality around the World

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  • Juan Ignacio Ruiz
  • Kaamel Nuhu
  • Justin Tyler McDaniel
  • Federico Popoff
  • Ariel Izcovich
  • Juan Martin Criniti

Abstract

Background: Maternal and infant mortality are highly devastating, yet, in many cases, preventable events for a community. The human development of a country is a strong predictor of maternal and infant mortality, reflecting the importance of socioeconomic factors in determinants of health. Previous research has shown that the Human Development Index (HDI) predicts infant mortality rate (IMR) and the maternal mortality ratio (MMR). Inequality has also been shown to be associated with worse health in certain populations. The main purpose of the present study was to determine the correlation and predictive power of the Inequality Adjusted Human Development Index (IHDI) as a measure of inequality with the Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), Early Neonatal Mortality Rate (ENMR), Late Neonatal Mortality Rate (LNMR), and the Post Neonatal Mortality Rate (PNMR). Methods and Findings: Data for the present study were downloaded from two sources: infant and maternal mortality data were downloaded from the Global Burden of Disease 2013 Cause of Death Database and the Human Development Index (HDI) and Inequality-Adjusted Human Development Index (IHDI) data were downloaded from the United Nations Development Program (UNDP). Pearson correlation coefficients were estimated, following logarithmic transformations to the data, to examine the relationship between HDI and IHDI with MMR, IMR, ENMR, LNMR, and PNMR. Steiger’s Z test for the equality of two dependent correlations was utilized in order to determine whether the HDI or IHDI was more strongly associated with the outcome variables. Lastly, we constructed OLS regression models in order to determine the predictive power of the HDI and IHDI in terms of the MMR, IMR, ENMR, LNMR, and PNMR. Conclusions: Even when both the HDI and the IHDI correlate with the infant and maternal mortality rates, the IHDI is a better predictor for these two health indicators. Therefore, these results add more evidence that inequality is playing an important role in determining the health status of various populations in the world and more efforts should be put into programs to fight inequality.

Suggested Citation

  • Juan Ignacio Ruiz & Kaamel Nuhu & Justin Tyler McDaniel & Federico Popoff & Ariel Izcovich & Juan Martin Criniti, 2015. "Inequality as a Powerful Predictor of Infant and Maternal Mortality around the World," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-11, October.
    • Handle: RePEc:plo:pone00:0140796
    DOI: 10.1371/journal.pone.0140796
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    References listed on IDEAS

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    1. Ioana van Deurzen & Wim van Oorschot & Erik van Ingen, 2014. "The Link between Inequality and Population Health in Low and Middle Income Countries: Policy Myth or Social Reality?," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-22, December.
    2. Elgar, F.J., 2010. "Income inequality, trust, and population health in 33 countries," American Journal of Public Health, American Public Health Association, vol. 100(11), pages 2311-2315.
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    2. Seong-Uk Baek & Sung-Shil Lim & Jihyun Kim & Jin-Ha Yoon, 2019. "How Does Economic Inequality Affect Infanticide Rates? An Analysis of 15 Years of Death Records and Representative Economic Data," IJERPH, MDPI, vol. 16(19), pages 1-12, September.
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    4. Mamunur Rashid & Mohammad Rocky Khan Chowdhury & Manzur Kader & Anne-Sofie Hiswåls & Gloria Macassa, 2022. "Determinants of Utilization of Institutional Delivery Services in Zambia: An Analytical Cross-Sectional Study," IJERPH, MDPI, vol. 19(5), pages 1-13, March.

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