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Int. J. Environ. Res. Public Health 2013, 10(6), 2296-2335; doi:10.3390/ijerph10062296
Review

The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review

1,2,*  and 3
Received: 3 February 2013; in revised form: 26 April 2013 / Accepted: 16 May 2013 / Published: 5 June 2013
(This article belongs to the Special Issue Social and Economical Determinants of Health)
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Abstract: Infant mortality (IM) and birth outcomes, key population health indicators, have lifelong implications for individuals, and are unequally distributed globally. Even among western industrialized nations, striking cross-country and within-country patterns are evident. We sought to better understand these variations across and within the United States of America (USA) and Western Europe (WE), by conceptualizing a social determinants of IM/birth outcomes framework, and systematically reviewing the empirical literature on hypothesized social determinants (e.g., social policies, neighbourhood deprivation, individual socioeconomic status (SES)) and intermediary determinants (e.g., health behaviours). To date, the evidence suggests that income inequality and social policies (e.g., maternal leave policies) may help to explain cross-country variations in IM/birth outcomes. Within countries, the evidence also supports neighbourhood SES (USA, WE) and income inequality (USA) as social determinants. By contrast, within-country social cohesion/social capital has been underexplored. At the individual level, mixed associations have been found between individual SES, race/ethnicity, and selected intermediary factors (e.g., psychosocial factors) with IM/birth outcomes. Meanwhile, this review identifies several methodological gaps, including the underuse of prospective designs and the presence of residual confounding in a number of studies. Ultimately, addressing such gaps including through novel approaches to strengthen causal inference and implementing both health and non-health policies may reduce inequities in IM/birth outcomes across the western developed world.
Keywords: social determinants of health; infant mortality; birth outcomes; preterm birth; United States; Western Europe social determinants of health; infant mortality; birth outcomes; preterm birth; United States; Western Europe
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Kim, D.; Saada, A. The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review. Int. J. Environ. Res. Public Health 2013, 10, 2296-2335.

AMA Style

Kim D, Saada A. The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review. International Journal of Environmental Research and Public Health. 2013; 10(6):2296-2335.

Chicago/Turabian Style

Kim, Daniel; Saada, Adrianna. 2013. "The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review." Int. J. Environ. Res. Public Health 10, no. 6: 2296-2335.



Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert