Polity's Enduring Effect on Infant Health Outcomes.

ABSTRACT

OBJECTIVES: How a nation's style of governance (polity) affects infant health is not fully understood. Here, the effects of polity on infant mortality rates (IMRs) is evaluated across 164 nations over a 28-year period. METHODS: Variation in 2018 IMRs was examined in relation to Polity Scores from 1990 to 2017 that quantify autocratic-to-democratic propensities of governments. Regression coefficients of effect, adjusted for national differences in economic prosperity, income equity and gender parity are reported. RESULTS: IMRs and polity was inversely related and more strongly associated with greater time between measurements. 2018 IMRs decreased by 0.12 deaths for a unitary increase in 2017 Polity Scores and 0.84 deaths when 1990 Polity Scores were examined. A similar, but more intense pattern was found when Polity Scores were aggregated to represent Autocratic, Anocratic and Democratic governance. CONCLUSIONS FOR PRACTICE Beyond risks associated with birthright, behavior and physical environments, a nation's form of government has a real, enduring effect on infant health. A full measure of that association requires extended time for proper evaluation.