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Monday, September 13th, 2010 02:07 pm
The Gapminder  graph comparing infant mortality in different countries is really interesting.  There are four dimensions in the graph: population size, region, GDP/capita, and infant mortality (they do this by putting wealth on the x axis and infant mortaily on the y axis, and representing the countries with circles proportionate to the population size and colored for the region).  There's an apparent regional correlation, as evidenced by the clusters of color, but that's generally explainable by the strong correlation with wealth.  Wealth is a very strong correlation.  But you knew that.  What's interesting is to look at the circles that are well above or below the other circles at the same income level. 

First, some countries that are strikingly below the curve (that is, a lot less babies die there than in other countries of the same relative wealth). 

Starting from the left:  Eritrea, but their infant mortality rate is 41 per thousand (sixteen and a half times as high as the countries with the least infant mortality).  If Eritrea were in the expected slot on the graph, it would be something between 79 (Niger) and 90 (Mozambique). Those are really high numbers.  It's hard to imagine a life in which that many babies are dying all the time.  (The highest infant mortality rate is Afghanistan, with 165 per thousand -- more than 3 babies out of every two hundred that are born.  It's to be expected that Afghanistan's infant mortality rate would be high, because they've been in a civil war for ever and ever, but this is actually nauseatingly high).

The next infant mortality rate that sticks out on the low side is Vietnam.  It has about the same GDP ($2574 per capita) as India ($2622), but its infant mortality is 12 while India's is 52.  I really don't know why India should have more than four times as many babies die, relatively, as Vietnam.  I have an idea, but it's only based on a flimsy, flimsy understanding of the countries, and I'm saving it for the end.


The next one that sticks out on the low end is Cuba, with a GDP of $9278 and an infant mortality rate of 4.8: compare with South Africa with a GDP of $9429 and an infant mortality rate of 48.  You read that right:  South Africa has an infant mortality rate ten times higher than Cuba.  But there's a reason here, I think: South Africa is in the middle of a really horrendous pandemic, and a lot of mothers are dying too.  when mothers die, their babies have a harder time staying alive.

After that, it's the usual suspects: Sweden, Japan, and Singapore, all with very high GDP and very low infant mortality (Japan is 2.5, the others are 2.3).  I was tempted to explain Singapore by saying that it is actually less of a country than a gated community, but the countries closest to it tend to be right on the curve for their income except for Vietnam.  Well, maybe the explanation still holds, because Singapore is wildly more welathy than its neighbors.

On the high end -- countries that have markedly higher infant mortality than others with similar GDP -- there's more outliers and I don't feel like listing them all individually.  But they do cluster regionally: Africa, the Middle East, and the Caribbean have more than their share of high-end outliers than other parts of the world.

I expected the US to be an outlier, from what I've been hearing lately.  But it's not much of one.  If you were to draw the curve that emerges from the graph, the US is barely higher than you'd expect it to be (less than three times higher than Singapore!).  I don't think I'd even call that outlying, really.  We're really overshadowed by the rich Arab countries.


I sort of want to explain this all by looking at internal inequalities, but that's clearly not the only story.  South Africa, for example, has some pretty stark inequalities, but it also has that pesky pandemic.  And the African countries have a powerful blend of war, famine, and severe post-colonial exploitation going on.

But I do want to congratulate all the outliers on the low side, and commiserate with all the countries with high infant mortality, outliers and curve-huggers alike.
Monday, September 13th, 2010 09:36 pm (UTC)
Might population density/infrastructure level be another aspect of explaining some of the differences? Lowering rural infant mortality is a different sort of problem than lowering urban (or relatively high density) infant mortality just because medical care is likely to be farther away.
Monday, September 13th, 2010 09:48 pm (UTC)
Those are, of course, two things, but yes, I'm sure they operate as factors of their own.

I can imagine how to set up the regressions you'd ahve to do to tease these out, but I doubt that all the information on all the relevant factors is all that available. But if it is, it's probably at Gapminder.
Monday, September 20th, 2010 07:46 am (UTC)
On density and infrastructure, I'd wonder if water quality and sewage treatment was a big factor. With lower density it would be more expensive, I'd think. And isn't diarrhea one of the big causes of infant mortality historically?
Monday, September 13th, 2010 11:33 pm (UTC)
My understanding is that the problems in the U.S. aren't so much infant *mortality* as an abnormally high rate of c-section, and a disproportionate to wealth ratio of low-birth-weight babies.
Monday, September 13th, 2010 11:44 pm (UTC)
Gosh that's interesting.