Document Detail

The Matthew effect: infant mortality in Canada and internationally.
MedLine Citation:
PMID:  10878174     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine whether the magnitude of improvement in the health status of a population over time is dependent on the previous health status of that population. DESIGN AND SETTING: A study of infant mortality rates in Canada's 12 provinces and territories between the periods 1961-1965 and 1991-1995, and of infant mortality rates in 133 countries between 1960 and 1995. MAIN OUTCOME MEASURES: Spearman's rank correlations, relative risks, and risk differences to measure the relationship between infant mortality in the 1960s and changes in infant mortality between the 1960s and 1990s. RESULTS: In Canada, regional rankings based on infant mortality rates in 1961-1965 were strongly correlated (inversely) with rankings based on the percent change in infant mortality between 1961-1965 and 1991-1995 (correlation coefficient = -.85). In contrast, internationally, rankings based on infant mortality rates in 133 countries in 1960 were positively correlated with percent change between 1960 and 1995 (correlation coefficient =.56). Regional differences in infant mortality rates, measured using relative risks, declined in Canada (highest relative risk: 4.2, compared with Ontario in the 1960s; highest relative risk: 2.2, compared with Ontario in the 1990s) but increased globally (highest relative risk: 5.0, compared with industrialized countries in 1960; highest relative risk: 15.1, compared with industrialized countries in 1995). CONCLUSIONS: Canadian regions with higher infant mortality rates in 1961-1965 achieved larger improvements compared with regions with initially lower infant mortality rates. The pattern observed within Canada is unlike the pattern observed internationally.
S Dzakpasu; K S Joseph; M S Kramer; A C Allen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  106     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-07-17     Completed Date:  2000-07-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  E5     Citation Subset:  IM    
Bureau of Reproductive and Child Health, Laboratory Centre for Disease Control, Ottawa, Canada.
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MeSH Terms
Developed Countries
Health Status
Infant Mortality*
Psychosocial Deprivation
World Health

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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