Abstract
Policy-oriented population health targets, such as the Millennium Development Goals and national targets to address health inequities, are typically based on trends of a decade or less. To test whether expanded timeframes might be more apt, we analyzed 50-year trends in US infant death rates (1960–2010) jointly by income and race/ethnicity. The largest annual per cent changes in the infant death rate (between −4 and −10 per cent), for all racial/ethnic groups, in the lowest income quintile occurred between the mid-1960s and early 1980s, and in the second lowest income quintile between the mid-1960s and 1973. Since the 1990s, these numbers have hovered, in all groups, between −1 and −3 per cent. Hence, to look back only 15 years (in 2014, to 1999) would ignore gains achieved prior to the onset of neoliberal policies after 1980. Target setting should be informed by a deeper and longer-term appraisal of what is possible to achieve.
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Using 50-year trends in US infant death rates by income and race/ethnicity,these researchers found the largest changes occurred early in the period. If recent trends alone were used for target setting would they would have ignored early gains, achieved before the onset of neo-liberal policies.
Appendix
Appendix
US infant death rates: rate difference and rate ratio, comparing black infants and infants of color to white infants, for the total population and by income quintile, 1960–2010.
US infant death rates (3-year moving average), and rate difference and rate ratio by income quintile, for the total US population and by race/ethnicity (non-Hispanic black, non-Hispanic white, Hispanic, Asian and Pacific Islander, and American Indian and Alaska Native), 1999–2010.
US infant death rates: rate difference and rate ratio, by race/ethnicity (comparing non-Hispanic black, Hispanic, Asian and Pacific Islander, and American Indian and Alaska Native infants to non-Hispanic white infants), for the total population and by income quintile, 1999–2010.
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Krieger, N., Singh, N., Chen, J. et al. Why history matters for quantitative target setting: Long-term trends in socioeconomic and racial/ethnic inequities in US infant death rates (1960–2010). J Public Health Pol 36, 287–303 (2015). https://doi.org/10.1057/jphp.2015.12
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DOI: https://doi.org/10.1057/jphp.2015.12