Polity's Enduring Effect on Infant Health Outcomes

Objectives How a nation's style of governance (polity) affects infant health is not fully understood. Here, the effects of polity on infant mortality rates (IMRs) is evaluated across 164 nations over a 28-year period. Methods Variation in 2018 IMRs was examined in relation to Polity Scores from 1990 to 2017 that quantify autocratic-to-democratic propensities of governments. Regression coefficients of effect, adjusted for national differences in economic prosperity, income equity and gender parity are reported. Results IMRs and polity was inversely related and more strongly associated with greater time between measurements. 2018 IMRs decreased by 0.12 deaths for a unitary increase in 2017 Polity Scores and 0.84 deaths when 1990 Polity Scores were examined. A similar, but more intense pattern was found when Polity Scores were aggregated to represent Autocratic, Anocratic and Democratic governance. Conclusions for Practice Beyond risks associated with birthright, behavior and physical environments, a nation's form of government has a real, enduring effect on infant health. A full measure of that association requires extended time for proper evaluation.