Journal article
State and Local Government Expenditures and Infant Mortality in the United States
Pediatrics (Evanston), v 146(5), pe20201134
Nov 2020
PMID: 33077541
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Evidence suggests that government expenditures on non-health care services can reduce infant mortality, but it is unclear what types of spending have the greatest impact among groups at highest risk. Thus, we sought to quantify how US state government spending on various services impacted infant mortality rates (IMRs) over time and whether spending differentially reduced mortality in some subpopulations.
A longitudinal, repeated-measures study of US state-level infant mortality and state and local government spending for the years 2000-2016, the most recent data available. Expenditures included spending on education, social services, and environment and housing. Using generalized linear regression models, we assessed how changes in spending impacted infant mortality over time, overall and stratified by race and ethnicity and maternal age group.
State and local governments spend, on average, $9 per person. A $0.30 per-person increase in environmental spending was associated with a decrease of 0.03 deaths per 1000 live births, and a $0.73 per-person increase in social services spending was associated with a decrease of 0.02 deaths per 1000 live births. Infants born to mothers aged <20 years had the single greatest benefit from an increase in expenditures compared with all other groups. Increased expenditures in public health, housing, parks and recreation, and solid waste management were associated with the greatest reduction in overall IMR.
Investment in non-health care services was associated with lower IMRs among certain high-risk populations. Continued investments into improved social and environmental services hold promise for further reducing IMR disparities.
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Details
- Title
- State and Local Government Expenditures and Infant Mortality in the United States
- Creators
- Neal D Goldstein - Departments of Epidemiology and Biostatistics andAimee J Palumbo - Temple UniversityScarlett L Bellamy - Departments of Epidemiology and Biostatistics andJonathan Purtle - Drexel UniversityRobert Locke - Thomas Jefferson University
- Publication Details
- Pediatrics (Evanston), v 146(5), pe20201134
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics; Health Management and Policy
- Web of Science ID
- WOS:000589620500063
- Scopus ID
- 2-s2.0-85095461830
- Other Identifier
- 991019167750504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics