Effects of food price inflation on infant and child mortality in developing countries

A better integration of health and economic impact assessments of climate change

Climate change could lead to high economic burden for individuals (i.e. low income and high prices). While economic conditions are important determinants of climate change vulnerability, environmental epidemiological studies focus primarily on the direct impact of temperature on morbidity and mortality without accounting for climate-induced impacts on the economy. More integrated approaches are needed to provide comprehensive assessments of climate-induced direct and indirect impacts on health. This paper provides some perspectives on how epidemiological and economic impact assessments could be better integrated. We argue that accounting for the economic repercussions of climate change on people's health and, vice versa, the consequences of health effects on the economy could provide more realistic scenario projections and could be more useful for adaptation policy.

COVID-19's death transfer to Sub-Saharan Africa

The COVID-19 spread very quickly around the world following its discovery in China, in December 2019. Lockdowns implemented in China and the Global North to control the propagation of the virus and to save human lives have resulted in a global recession. The transmission of the recessionary effects from the Global North to the Global South is reflected in the decline in sub-Saharan Africa's (SSA) GDP and the associated increase in poverty. The purpose of this paper is to illustrate how the recession induced in China and the Global North by COVID-19 lockdowns may have had indirect effects on SSA mortality that are higher than those directly attributed to the pandemic itself. Our methodology relies on a three-step relationship: (i) the impact of lockdowns on the recession in the North, (ii) the impact of the recession in the North on income in SSA countries, and (iii) the impact of a decline in income on mortality in SSA. We show that COVID-19-induced lockdowns in the Global North, through the severe recessions they induced in the Global South, resulted in the transfer of between 538,000 and 679,000 deaths in one year to SSA, including the deaths of 140,000 to 177,000 children aged 0-5 years. This corresponds to a 6-7% increase in the crude death rate and a 5-6% increase in under-5 mortality. These figures are much higher than the number of deaths directly attributable to COVID-19 in SSA. Thus, policymakers must not lose sight of the indirect excess mortality caused by global economic recession triggered by the pandemic. Our results reveal the need to increase the resilience of SSA countries to exogenous shocks, including COVID-19, which, in addition to increasing poverty, may induce excessive mortality due to the high sensitivity of mortality in SSA countries to economic recession.

Decomposing inequality of opportunity in child health in Tanzania: The role of access to water and sanitation

Poor child nutrition is a major public health challenge in Tanzania. Large between and within regional nutritional inequalities exist in rural and urban areas. We looked at how locational circumstances hinder children from having an equal opportunity for good nutrition. We used the 2008/09 Living Standards Measurement Study data for Tanzania to identify the part played by water and sanitation in rural and urban inequality of opportunity in child nutrition. We used the dissimilarity index and the Shapley decomposition technique to quantify and decompose inequality of opportunity in nutrition. We find that 16% of the circumstance-driven inequality of opportunity needs to be redistributed for equality of opportunity to prevail. We find that in rural areas, about 42% of the inequality of opportunity in nutrition is due to water and sanitation problems and 22% to child age. In urban areas, we find that the inequality of opportunity is related mainly to the child's sex, price fluctuations and intergenerational factors. The findings suggest that policies to improve water and sanitation coverage could help equalize opportunities for children in rural areas. In urban areas, policies that could help equalize opportunities require incentives to change social norms and behavior around feeding practices and vaccination.

The importance of elders: Extending Hamilton's force of selection to include intergenerational transfers

Prominent explanations for postreproductive longevity emphasize the myriad ways in which older adults help descendants in social species. However, standard metrics expressing how natural selection acts with age show declines in tandem with reproduction, rendering postreproductive life vulnerable to harmful mutations. Here, we develop a framework for estimating three fitness metrics to characterize the “force of selection” in social species with pooled energy budgets. We show that intergenerational transfers of food and information in the complex, high-skill foraging niche typical of hunter-gatherers can select for longer lifespan via inclusive fitness benefits. Our findings support the theory that postreproductive life in some mammals coevolved with multigenerational cooperation in a complex foraging niche and help explain selection against late-acting deleterious alleles.

In classical evolutionary models, the force of natural selection diminishes with age toward zero by last reproduction. However, intergenerational resource transfers and other late-life contributions in social species may select for postreproductive longevity. We present a formal framework for estimating indirect fitness contributions via production transfers in a skills-intensive foraging niche, reflecting kinship and cooperation among group members. Among contemporary human hunter-gatherers and horticulturalists, indirect fitness contributions from transfers exceed direct reproductive contributions from before menopause until ages when surpluses end, around the modal age of adult death (∼70 y). Under reasonable assumptions, these benefits are the equivalent to having up to several more offspring after age 50. Despite early independence, minimal production surplus, and a shorter lifespan, chimpanzees could theoretically make indirect contributions if they adopted reliable food-sharing practices. Our results for chimpanzees hypothetically adopting hunter-gatherer subsistence suggest that a skills-intensive foraging ecology with late independence and late peak production could select for human-like life histories via positive feedback between longevity and late-life transfers. In contrast, life history changes preceding subsistence shifts would not favor further life extension or subsistence shifts. Our results formalize the theory that longevity can be favored under socioecological conditions characterized by parental and alloparental care funded through transfers of mid- to late-life production surpluses. We also extend our analysis beyond food transfers to illustrate the potential for indirect fitness contributions from pedagogy, or information transfers. While we focus mostly on humans, our approach is adaptable to any context or species where transfers can affect fitness.

The correlation between food insecurity and infant mortality in North Carolina

OBJECTIVE

Food insecurity (FI) affects approximately 11·1 % of US households and is related to worsened infant outcomes. Evidence in lower income countries links FI and infant mortality rates (IMR), but there are limited data in the USA. This study examines the relationship between FI and IMR in North Carolina (NC).

DESIGN

NC county-level health data were used from the 2019 Robert Woods Johnson Foundation County Health Rankings. The dependent variable was county-level IMR. Eighteen county-level independent variables were selected and a multivariable linear regression was performed. The independent variable, FI, was based on the United States Department of Agriculture's Food Security Supplement to the Current Population Survey.

SETTING

NC counties.

PARTICIPANTS

Residents of NC, county-level data.

RESULTS

The mean NC county-level IMR was 7·9 per 1000 live births compared with 5·8 nationally. The average percentage of county population reporting FI was 15·4 % in the state v. 11·8 % nationally. Three variables statistically significantly predicted county IMR: percent of county population reporting FI; county population and percent population with diabetes (P values, respectively, < 0·04; < 0·05; < 0·03). These variables explained 42·4 % of the variance of county-level IMR. With the largest standardised coefficient (0·247), FI was the strongest predictor of IMR.

CONCLUSIONS

FI, low birth weight and diabetes are positively correlated with infant mortality. While correlation is not causation, addressing FI as part of multifaceted social determinants of health might improve county-level IMR in NC.

Real Estate Prices, Inflation, and Health Outcomes: Evidence From Developed Economies

Population health is a key pillar of the fast-growing economies, but several challenges threaten it. This study scrutinizes the impact of real estate prices (housing rent) and inflation on population health by using advanced economies from 1996 to 2019. Health is measured by infant mortality rates and life expectancy at birth. The empirical outcomes show a positive and significant effect of housing rent on the infant mortality rate. In contrast, housing rent improves life expectancy. We also find that an increase in inflation positively affects the infant mortality rate and has a negative effect on life expectancy. GDP and health expenditure tend to improve health by increasing life expectancy and reducing the infant mortality rate. However, unemployment is harmful effects on population health. This study recommends that healthcare practitioners consider the housing market and inflationary pressure.

Trends in Under-5 Mortality Rates and Their Associations with Socioeconomic Factors Among Countries Participating in the Belt and Road Initiative: A Panel Data Analysis

Purpose

The Belt and Road Initiative (BRI) provided a platform to promote trade and economic collaboration, with health promotion also being an important component. This study examined the burden of the under-5 mortality rate (U5MR) among BRI countries and studied the impact of socioeconomic development on the U5MR.

Patients and Methods

Data were collected from 137 BRI countries for the period 2000–2018. The temporal changes in the U5MR and the estimated annual percentage change (EAPC) were used to assess the U5MR burden. A quantile fixed-effects model was used to access the associations between socioeconomic factors and the U5MR.

Results

The U5MR varied widely among the 137 analyzed countries in 2018, being highest in Somalia (121.5 per 1000) and lowest in Slovenia (2.1 per 1000). The decreasing trend in U5MR was largest in Montenegro (EAPC = –9.6, 95% confidence interval [CI] = –10.2 to –9.0), while the increasing trend was largest in Dominica (EAPC = 6.0, 95% CI = 5.3 to 6.7). Countries with higher U5MRs in 2000 experienced more rapid decreases in the U5MR from 2000 to 2018. The influence of socioeconomic factors on U5MR was related to the distribution of U5MR.

Conclusion

The U5MR remains a major public-health issue in some BRI countries. Improving the economic situation will benefit child health in BRI countries in the long run.

Child mortality, commodity price volatility and the resource curse

Given many developing economies depend on primary commodities, the fluctuations of commodity prices may imply significant effects for the wellbeing of children. To investigate, this paper examines the relationship between child mortality and commodity price movements as reflected by country-specific commodity terms-of-trade. Employing a panel of 69 low and lower-middle income countries over the period 1970-2010, we show that commodity terms-of-trade volatility increases child mortality in highly commodity-dependent importers suggesting a type of 'scarce' resource curse. Strikingly however, good institutions appear able to mitigate the negative impact of volatility. The paper concludes by highlighting this tripartite relationship between child mortality, volatility and good institutions and posits that an effective approach to improving child wellbeing in low to lower-middle income countries will combine hedging, import diversification and improvement of institutional quality.