title: The role of political and welfare state characteristics in infant mortality: a comparative study in wealthy countries since the late 19th century.
abstract: BACKGROUND
  A close examination of the literature suggests that the consistent relation between political and welfare state characteristics and infant mortality in the second half of the 20th century in wealthy countries may not be causal.
  
  
  METHODS
  The evolution of infant mortality since the late 19th century was studied in 17 wealthy countries classified according to political traditions, family policy model and period of infant mortality transition. The relation of public health expenditure and income inequality to infant mortality from 1980 to 2005 was also evaluated.
  
  
  RESULTS
  The Social Democratic and Scandinavian countries, and those with the earliest transition in infant mortality, had the lowest infant mortality rates until the early 21st century, whereas the late democracies, the Southern European countries, and those in which the transition in infant mortality took place later, had the highest rates until the late 20th century. By the early 21st century, the differences in infant mortality were negligible. Three of the four Scandinavian countries were the first to achieve infant mortality transition, whereas the Southern European countries were the last. The relation between public health expenditure and infant mortality varied depending on the time period in which the analysis was made, and increased income inequality was associated with higher infant mortality.
  
  
  CONCLUSIONS
  The relation between political and welfare state characteristics and infant mortality in previous studies probably reflects the historical moment in which the transition in infant mortality took place in each country. Methodological limitations do not allow inference of causality in the associations found between welfare state characteristics and infant mortality.
authors: Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Ciudad Universitaria, Madrid, Spain. enriqueregidor@hotmail.com
authors: Enrique
authors: E
authors: Regidor
authors: Cruz
authors: C
authors: Pascual
authors: David
authors: D
authors: Martínez
authors: María E
authors: ME
authors: Calle
authors: Paloma
authors: P
authors: Ortega
authors: Paloma
authors: P
authors: Astasio
mesh_terms: D002170:Canada / Q000453:epidemiology; D019049:Developed Countries / Q000191:economics; D005060:Europe / Q000453:epidemiology; D006801:Humans; D007182:Income; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D011057:Politics; D015980:Public Health Practice / Q000191:economics; D012044:Regression Analysis; D012946:Social Welfare; D014481:United States / Q000453:epidemiology