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The Matthew effect: infant mortality in Canada and internationally
S Dzakpasu1, K S Joseph, M S Kramer
1Bureau of Reproductive and Child Health, Laboratory Centre for Disease Control, Ottawa, Canada. susie_dzakpasu@hc-sc.gc.ca
Pediatrics
|July 6, 2000
Summary
Canadian regions with higher infant mortality rates saw greater improvements than those with lower rates. This contrasts with international trends, where higher initial rates did not guarantee larger declines in infant mortality.
Area of Science:
- Public Health
- Epidemiology
- Demography
Background:
- Population health status improvements over time may vary based on initial health levels.
- Understanding these dynamics is crucial for targeted public health interventions.
- Infant mortality rates serve as a key indicator of population health.
Purpose of the Study:
- To investigate if the extent of population health improvement is linked to the population's prior health status.
- To analyze the relationship between initial infant mortality rates and subsequent changes in these rates.
Main Methods:
- Analysis of infant mortality rates in Canadian provinces/territories (1961-1965 vs. 1991-1995).
- Examination of infant mortality rates in 133 countries (1960 vs. 1995).
- Statistical methods included Spearman's rank correlations, relative risks, and risk differences.
Main Results:
- Canadian regions with higher 1961-1965 infant mortality rates showed stronger inverse correlation with improvement (r = -.85).
- Internationally, higher 1960 infant mortality rates showed positive correlation with improvement (r = .56).
- Regional infant mortality disparities decreased in Canada but increased globally.
Conclusions:
- Canadian regions with higher initial infant mortality rates experienced greater improvements.
- The pattern of health improvement differs significantly between Canada and the international context.
- Initial health status is a significant factor in the magnitude of subsequent health improvements within Canada.