Though the infant mortality rate in the United States has decreased by 77 percent in the last 50 years (from 25.2 per 1000 births in 1963 to 5.9 in 2013), the U.S. is still worse off in this department than many other developed countries. In 2013, the U.S. was behind much of Europe, Australia, South Korea, Cuba, and Japan, among others. (Monaco had the lowest infant mortality rate in 2013—1.81 per 1000 births.) New research published in The International Journal of Epidemiology suggests that political factors may be affecting U.S. infant mortality.
"Infant mortality has been sensitive to all sorts of social contextual factors—from nutritional factors, to access to health services, to stress during pregnancy," says Arline T. Geronimus, a research professor at the University of Michigan's Population Studies Center, and a co-author on the study. "One might imagine [these factors] would be affected by political climates, ideologies, or policy."
With this in mind, the researchers investigated the effect of the president's political party on the infant mortality rate. They looked at data from 1965 to 2010, from the U.S. National Vital Statistics Reports, and only accounted for the president’s political party, leaving out all other factors that could affect mortality rates, like advances in medical technology. They also delayed considering the president “in power” by one year, since it would likely take some time for him to affect mortality.
What they found is that, relative to the overall trend, infant mortality rates were, on average, 3 percent higher during Republican presidencies, and 1 percent lower during Democratic presidencies. Though the effect is proportionally the same across races; because infant mortality rates are already more than twice as high for black citizens as white citizens, presidential party affiliation ends up affecting the black population more.
In the chart below, you can see this broken down by president (the straight line is the regression line of the overall trend). The Obama and Clinton years were the lowest, while the span of Ronald Reagan/George H.W. Bush is generally the time of highest infant mortality.
In the discussion section of the study, the researchers posit that this may be because Republicans “are more likely to view health disparities as inevitable,” and not a matter that government should intervene on, while Democrats tend to think health disparities are “a preventable social problem.”
“Although this is an oversimplified rendering of the differences in the ideological traditions, it suggests one type of reason why one might expect Republican and Democratic presidents to affect population health differently,” the study reads.
The researchers are sure to note that the correlation may be spurious—there could, of course, be other hidden factors at play. "We don't expect to find a direct causal link to one policy or one specific thing," Geronimus says. "There's nothing intentional implied."
But, she says, spurious is not the same thing as "accidental."
"While we don’t want to jump to conclusions that there’s anything directly that a Republican president or a Democratic president does that affects the infant mortality rate, I think the strength of the association, [considering] the variables we controlled for suggests that there’s a clue here," Geronimus says. "Infant mortality in the U.S. has been way too high for way too long... I think the right spirit of this paper is to generate new lines of research that maybe take slightly different directions than what's been done to date."