Introduction
State policies and programs affect population health; yet, little is known about the
connections between health and the political institutions and actors that prescribe
and execute those policies and programs.
Methods
The 2-way fixed-effects regression models were fitted to data from the National Center
for Health Statistics, 1969–2014, to estimate logged infant mortality rate differentials
between Republican- and non-Republican‒controlled state legislatures. These data were
used in 2020 to hypothesize that net of trend, fluctuations in infant mortality rates—overall
and by race—correlate with the party that controls state legislatures (the Lower House,
the Upper House, and Congress).
Results
Findings show that state infant and postneonatal mortality rates are substantively
higher under Republican-controlled state legislatures than under non-Republican‒controlled
ones. The effect size is larger for postneonatal than for neonatal mortality. Findings
suggest that effects may be greater for Black than for White infants, although the
race-specific results are estimated imprecisely. The governor's party shows no substantive
impacts on infant mortality rates net of party control of the Lower House.
Conclusions
Findings support the proposition that the social determinants of health are constructed,
at least in part, by the power vested in governments.
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Publication history
Published online: August 23, 2021
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
