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Partisan Control of U.S. State Governments: Politics as a Social Determinant of Infant Health

  • Javier M. Rodriguez
    Correspondence
    Address correspondence to: Javier M. Rodriguez, PhD, Department of Politics & Government, School of Social Science, Policy & Evaluation, Claremont, Graduate University, 170 East 10th Street, Claremont CA 91711.
    Affiliations
    Department of Politics & Government, School of Social Science, Policy & Evaluation, Claremont, Graduate University, Claremont, California
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  • Arline T. Geronimus
    Affiliations
    Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan

    Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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  • John Bound
    Affiliations
    Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan

    Department of Economics, LSA College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, Michigan
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  • Rixin Wen
    Affiliations
    Department of Politics & Government, School of Social Science, Policy & Evaluation, Claremont, Graduate University, Claremont, California
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  • Christina M. Kinane
    Affiliations
    Department of Political Science, Yale University, New Haven, Connecticut
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      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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