Why history matters for quantitative target setting: long-term trends in socioeconomic and racial/ethnic inequities in US infant death rates (1960–2010)

Policy-oriented population health targets, such as the Millennium Development Goals and national targets to address health inequities, typically are based on trends of a decade or less. To test whether expanded timeframes might be more apt, we analyzed 50-year trends in US infant death rates (1960–2010) jointly by income and race/ethnicity. The largest annual percent changes in the infant death rate (between −4% and −10%) occurred, for all racial/ethnic groups, in the lowest income quintile between the mid-1960s and early 1980s, and in the second lowest income quintile between the mid-1960s and 1973; since the 1990s, they have hovered, in all groups, between −1% and −3%. Hence, to look back only 15 years, in 2014, to 1999, would ignore gains achieved prior to the post-1980 onset of neoliberal policies. Target setting should be informed by a deeper and more long-term appraisal of what is possible to achieve.

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Authors: Nancy Krieger, Nakul Singh, Jarvis T. Chen, Jason Beckfield, Matthew V. Kiang, Pamela D. Waterman, Sofia Gruskin
Published By: Journal of Public Health Policy
Date: August 1, 2015
Publication Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711344/pdf/nihms749715.pdf