The post-1965 reductions in United States infant mortality: a national or international phenomenon?

The extent to which post-1965 declines in infant mortality could be attributed to (1) US medical and antipoverty programs and/or (2) internationally available medical advances was examined using data on infant, neonatal, and postneonatal mortality rates (IMRs, NMRs, PNMRs) in four western countries. The results showed that while post-1965 improvements occurred internationally, the US IMR improvements doubled that occurring elsewhere. Much of this advantage was attributable to post-1965 US PNMR improvements, which more than offset a slowing in the reduction of international PNMRs. In contrast, international effects contributed more to US declines in NMRs than did uniquely-United States factors.