Immpact, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
BMC Public Health. 2010 Nov 24;10:727. doi: 10.1186/1471-2458-10-727.
The effect of the recent world recession on population health has featured heavily in recent international meetings. Maternal health is a particular concern given that many countries were already falling short of their MDG targets for 2015.
We utilise 20th century time series data from 14 high and middle income countries to investigate associations between previous economic recession and boom periods on maternal and infant outcomes (1936 to 2005). A first difference logarithmic model is used to investigate the association between short run fluctuations in GDP per capita (individual incomes) and changes in health outcomes. Separate models are estimated for four separate time periods.
The results suggest a modest but significant association between maternal and infant mortality and economic growth for early periods (1936 to 1965) but not more recent periods. Individual country data display markedly different patterns of response to economic changes. Japan and Canada were vulnerable to economic shocks in the post war period. In contrast, mortality rates in countries such as the UK and Italy and particularly the US appear little affected by economic fluctuations.
The data presented suggest that recessions do have a negative association with maternal and infant outcomes particularly in earlier stages of a country's development although the effects vary widely across different systems. Almost all of the 20 least wealthy countries have suffered a reduction of 10% or more in GDP per capita in at least one of the last five decades. The challenge for today's policy makers is the design and implementation of mechanisms that protect vulnerable populations from the effects of fluctuating national income.
最近的全球经济衰退对人口健康的影响在最近的国际会议上备受关注。鉴于许多国家已经无法实现 2015 年千年发展目标中的孕产妇健康目标，孕产妇健康是一个特别令人关注的问题。
我们利用来自 14 个高收入和中等收入国家的 20 世纪时间序列数据，研究了前几次经济衰退和繁荣时期与母婴结局（1936 年至 2005 年）之间的关联。使用一阶差分对数模型来研究人均 GDP（个人收入）的短期波动与健康结果变化之间的关系。分别为四个不同时期估计了单独的模型。
结果表明，母婴死亡率与经济增长之间存在适度但显著的关联，特别是在早期（1936 年至 1965 年），但在最近的时期则没有。个别国家的数据显示出对经济变化的反应模式明显不同。日本和加拿大在战后时期容易受到经济冲击的影响。相比之下，英国、意大利和特别是美国等国家的死亡率似乎不受经济波动的影响。
所提供的数据表明，衰退确实与母婴结局存在负相关关系，特别是在一个国家发展的早期阶段，但在不同的体系中影响差异很大。在过去的五十年中，至少有 20 个最不发达国家中有 10%或更多的国家人均 GDP 至少下降了一次。当今政策制定者面临的挑战是设计和实施保护脆弱人群免受国家收入波动影响的机制。
