title: A longitudinal ecological study of the influences of political, economic, and health services characteristics on under-five mortality in less-developed countries.
abstract: This study used a longitudinal dataset and lagged dependent-variable panel regression models to examine whether political and economic characteristics directly predict under-5-year mortality rates (U5MR), and moderate the effects of health services and environment on U5MR. We used a sample of 46 less-developed countries from 1980 to 2009. Our results showed that the effects of political and economic characteristics on U5MR varied by non-sub-Saharan and sub-Saharan countries. After controlling for baseline U5MR and other socioeconomic variables, while foreign investment and health services were negatively associated U5MR, democracy was positively associated with U5MR in nonsub-Saharan countries. In contrast, debt was positively associated with and democracy and foreign investment were negatively associated with U5MR in sub-Saharan countries. The interaction analyses indicated that for sub-Saharan countries, the effects of health services on U5MR only existed for countries with low foreign investment.
authors.affiliation: School of Public Health, Taipei Medical University, 250 Wu-Hsing St., Taipei 106, Taiwan. yingchih@tmu.edu.tw
authors.forename: Ying-Chih
authors.initials: YC
authors.lastname: Chuang
authors.forename: Pei-Wei
authors.initials: PW
authors.lastname: Sung
authors.forename: Hsing Jasmine
authors.initials: HJ
authors.lastname: Chao
authors.forename: Chyi-Huey
authors.initials: CH
authors.lastname: Bai
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Chang
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D019049:Developed Countries / Q000191:economics / Q000706:statistics & numerical data; D003906:Developing Countries; D006296:Health Services; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D008137:Longitudinal Studies; D011057:Politics; D011204:Poverty Areas
keywords: Democracy; Health services; Less-developed countries; Longitudinal data; Under-5-year mortality rate