Population-Based Study of Child Mortality (0-4) and Income Inequality in Japan and the Developed world 1989-91 v 2012-14: Any Excess Deaths Between the Most Unequal Countries?
0
Citation
4
Reference
20
Related Paper
Abstract:
Introduction: Parental child `neglect’ is usually linked to parents but can apply to nations using the criteria explicit in UNICEF statement “in the last analysis Child-Mortality-Rates (CMR) indicates how well a nation meets the needs of its children”. Hence under-five (0-4) CMR rates of Japan and twenty Other Developed Countries (ODC) are compared within the context of relative poverty. Method: WHO data yields CMR rates per million (pm), analysed between 1989-91 and 2012-14 to compare Japan against ODC. World Bank Income Inequality data used as a measure of relative poverty. Excess deaths calculated by matching the most unequal Income Inequality country’s CMR with the most equal nation. Results: All countries reduced CMR substantially. The highest CMR was in USA 1383pm, followed by three English-speaking countries. Japan at 597pm was 19th of 21. USA and New Zealand were double Japan’s CMR, whilst twelve ODC had rates 25% higher than Japan. Most unequal Income Inequality USA at 15.9 times, Japan the most equal at 4.5 times. Income Inequality and CMR were strongly correlated (+0.6188 p<0.005). The countries with the lowest Income Inequality, had lowest CMR namely Finland Japan, Norway and Sweden. America not matching Japan’s CMR, meant an average excess of 16,838 US children’s deaths annually. Discussion: The strong statistical association between higher CMR and Income Inequality, suggests that one factor in Japan’s results is the lower social inequality, unlike Canada, New Zealand, the UK and USA. Does Japan’s results indicate cultural factors suggesting Japan is more child orientated than English-speaking countries?Keywords:
Social Inequality
Cite
We study the factors that affect the number of coronavirus (COVID-19) deaths among low-income and high-income countries. Low-income countries report a significantly lower average number of deaths at 20 and 40 days post the first five deaths compared to high-income countries. We focus on factors that affect either the speed of transmission from susceptible to infected or the probability that an infected person dies. We then use the Oaxaca-Blinder decomposition to examine the sources of the differences in the average number of deaths between the two groups. We show that community mobility and the easiness of carrying the virus from one place to another, measured with the number of international arrivals, are significant factors affecting the number of deaths, while the governability of the population and life expectancy are only significant in high-income countries. Higher health expenditure and lower death rates are associated with more deaths in low-income countries. The differences in the number of deaths between the two groups can be linked to differences in the transportation infrastructure (number of arrivals), the shadow economy and life expectancy. Our study shows that mobility measures taken by individuals to limit the spread of the virus are important to prevent deaths in both high- and low-income countries. Additionally, our results suggest low-income countries with weak health institutions underestimate the number of deaths from COVID-19, compared to high-income countries. The underestimation of COVID-19 deaths could be affecting a great number of people in poverty in low-income economies.
Pandemic
2019-20 coronavirus outbreak
Cite
Citations (7)
This paper uses household surveys from 89 countries to estimate the rate of extreme poverty among children in the developing world. The estimates are based on the same surveys and welfare measures as official World Bank poverty estimates. Of children under age 18 years, 19.5 percent are estimated to live on less than $1.90 per day, as opposed to 9.2 percent of adults ages 18 and above. Poverty rates are high for children ages 0 to 4 years, slightly higher among ages 5 to 9 years, and steadily decline for successively older age groups. The analysis also examines the sensitivity of age-based poverty estimates to the use of alternative household equivalence scales when adjusting the international poverty line accordingly. Child poverty rates remain above 17 percent, and are greater than adult poverty rates, for all reasonable two-parameter equivalence scales.
Extreme poverty
Poverty rate
Cite
Citations (2)
Using data from the March Current Population Surveys in the United States, the Household Panel Survey in Great Britain and the Socio-Economic Panel in Germany we find gains from economic growth in the United States over their 1990s business cycle (1989-2000) were more equitably distributed than were the gains over their 1980s business cycle (1979-1989). Furthermore, they were more equitably distributed than were the gains in Germany over their 1990s business cycle (1991-2001). However, gains from economic growth in Great Britain over their 1990s business cycle (1990-2000) were the most equitably distributed. Our results hold using both summary measures of inequality as well as kernel density estimations. In the United States and Great Britain the entire income distribution moved upward in the 1990s. In Germany, as was the case in the United States over their 1980s business cycle, there was a drop in the middle of the income distribution and increases in both tails. In the United States, younger persons (aged 64 and younger) fared better than older persons (aged 65 and older) while the opposite was the case in Great Britain and Germany. Income inequality fell in all three countries among the older population. But it rose in Germany, remained about the same in the United States and fell in Great Britain among their younger populations.
Fell
Cite
Citations (12)
We estimate the world distribution of income by integrating individual income distributions for 125 countries between 1970 and 1998. We estimate poverty rates and headcounts by integrating the density function below the $1/day and $2/day poverty lines. We find that poverty rates decline substantially over the last twenty years. We compute poverty headcounts and find that the number of one-dollar poor declined by 235 million between 1976 and 1998. The number of $2/day poor declined by 450 million over the same period. We analyze poverty across different regions and countries. Asia is a great success, especially after 1980. Latin America reduced poverty substantially in the 1970s but progress stopped in the 1980s and 1990s. The worst performer was Africa, where poverty rates increased substantially over the last thirty years: the number of $1/day poor in Africa increased by 175 million between 1970 and 1998, and the number of $2/day poor increased by 227. Africa hosted 11% of the world’s poor in 1960. It hosted 66% of them in 1998. We estimate nine indexes of income inequality implied by our world distribution of income. All of them show substantial reductions in global income inequality during the 1980s and 1990s.
Liberian dollar
Extreme poverty
Cite
Citations (186)
Background: This study estimates the potential loss of life in children under five years old attributable to the economic recessions of 2020. Multiple prior studies have shown a strong and independent effect of GDP per capita on child mortality in developing countries after controlling for health system effects, demography, politics, environment, and literacy.Methods: Data were retrieved from the World Bank World Development Indicators database and the United Nations World Populations Prospects estimates for the years 1990-2020 for 129 countries with GDP per capita below 12,375 US$ (defined as low, lower-middle, and upper-middle income countries; LMICs). We used a multi-level, mixed effects, multivariate model to estimate the adjusted relationship between GDP per capita and the under-5 mortality rate (U5MR) specific to each country. The model's country-specific parameters were used to simulate the impact on U5MR due to reductions in GDP per capita of 5%, 10%, and 15%.Findings: In a conservative scenario, a 5% reduction in GDP per capita in 2020 is estimated to cause an additional 282,996 deaths in children under 5 in one year compared to a baseline of no economic recession. Recessions at 10% and 15% lead to higher losses of under-5 lives, increasing to 585,802 and 911,026 additional deaths, respectively. We estimate that nearly half of all the potential under-5 lives lost from economic recessions in LMICs are estimated to occur in Sub-Saharan Africa.Interpretation: In developing countries, under-5 mortality rates are closely tied to national income. We estimate that the recessions of 2020 will lead to around 300,000 deaths in the under-5 population. Our results do not take into account the irreparable effects of economic deprivation on child development. We expect to see similar trends of child mortality in the next few years in the absence of sufficient SARS-CoV-2 vaccination or herd immunity.Funding Statement: A grant from Big Win Philanthropy partially funded this study.Declaration of Interests: The authors declare no conflicts of interest.
Cite
Citations (0)
Fell
Total personal income
Family income
Adjusted gross income
Cite
Citations (69)
After independence most African countries witnessed growth in their economies and decreases in child mortality. However both economic growth and the gains in under 5 mortality slowed dramatically in the 1980s and 1990s1. The average under-5-mortality of countries in Sub Saharan Africa (SSA) reached a plateau's during the 1980s and early 1990s and only started to decrease again after 1995, this coincides with stagnant average incomes in SSA countries during this time period, see figure 1.
Figure 1
The average GDP per capita Purchasing Power Parity for countries in SSA excluding South Africa in USD and the U5M for these countries over the same period.
Comparing the annual rate of reduction in child mortality between 1970 and 2010 in two time periods, 1970 – 1990 and 1990 – 2010 and the GDP per capita annual growth rate over the same time period, two patterns emerge. Between 1970 and 1990 there was an association between the GDP per capita annual growth rate and the rate of reduction in under-five mortality, see figure 2. However, during the latter two decades there was no growth or shrinking of the average GDP per capita purchasing power parity (PPP) in the majority of countries in SSA, and no association with the annual rate of reduction of under-five mortality, see figure 3.
Figure 2
Economic growth and annual rate of reduction in child mortality, 1970–1990
Figure 3
Economic growth and annual rate of reduction in child mortality, 1990–2009
Is there an association between income, economic growth and child mortality?
Child mortality may be caused by distal, intermediate or proximal determinants of health2. Socioeconomic factors which have been shown to be important at the distal and intermediate level include income and maternal education3,4, the latter is influenced by the former5.
Many researchers have tried to establish the magnitude of the effect of country level income on average child mortality and they universally find that as income increases, child mortality significantly decreases. Research which has specifically looked at SSA confirms this trend for the continent6–9.
The majority of researchers control for variables which is known to influence child mortality, such as maternal education and health care, and still find a significant association between average child mortality rates and country level income. However, others point out that to control for intermediate determinants of health, such as maternal education is incorrect as these variables are a function of country level income and in fact are the mediators by which income influences mortality rather than being independent variables10.
Given that the economies of the majority of African countries were stagnant during the 1980s and 1990s and given the significant association between country level income and child mortality it is therefore not surprising that average under-five mortality during these decades reached a plateau.
Per capita income
Cite
Citations (1)
We examined the UK 's effectiveness in reducing Child Mortality with 20 other Western countries, in the context of their national health expenditures, and, relative poverty — measured by ‘Income Inequality’ the gap between top and bottom 20 per cent of income. W.H.O. Child (0–14) Mortality Rates ( CMR ) and GDP Expenditure on Health (% GDPHE ) were examined and a cost‐effectiveness ratio calculated, which is the reduced CMR over the period divided by average GDPHE . The highest average % GDPHE was USA at 13.2 per cent; the UK 's 7.3 per cent was equal lowest. The widest Income Inequality was USA 8.5 times; the UK at 7.2 was third widest. The highest CMR was the USA 2436 per million (pm), the UK 's 1630 pm, although representing a fall of 62 per cent was fourth highest. However, UK cost‐effectiveness ratio (1: 350) was eighth best of 21 countries. Only Income Inequality correlated significantly with CMR . UK CMR fell significantly more than five countries but ten others declined more. If UK deaths had been at the average of the 17 countries with lower CMR , there would have been 1827 fewer deaths. British children's poverty and health expenditure means they and their services are doubly disadvantaged although the NHS relatively achieved more with comparatively less.
Disadvantaged
Cite
Citations (11)
Income shares
Adjusted gross income
Cite
Citations (0)
Human Development Index
Per capita income
Cite
Citations (0)