PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

In developing countries, child-mortality rates fell most among poorest families

2014-11-10
(Press-News.org) The child-mortality gap has narrowed between the poorest and wealthiest households in a majority of more than 50 developing countries, a new study from the Stanford University School of Medicine has found.

This convergence was mostly driven by the fact that child-mortality rates declined the fastest among the poorest families. In the countries where the gap increased, the study identified a common thread: poor governance.

The findings provide important information for making decisions about prioritizing global health investments to effectively promote equity, said Eran Bendavid, MD, assistant professor of medicine and the study's author.

The study, which will be published online Nov. 10 in Pediatrics, analyzed data from nearly 1 million families living in 54 low- and middle-income countries to determine the relationship between mortality in children under the age of 5 and wealth inequality.

"In many countries, national wealth has increased hand-in-hand with increasing health inequality. That's been a signature of our time," Bendavid said. "It's a pressing concern for many societies, especially in wealthy countries, but it's also been an issue in low- and middle-income countries."

Assessing child mortality within developing countries

Many studies have assessed the national child mortality trends in developing countries, but they say little about the mortality gap between the poorest and wealthiest within those countries. National trends could be associated with either narrowing or widening gaps between the poorest and wealthiest populations, Bendavid noted. For example, if child mortality decreases faster among the wealthy compared with the poor, the overall child-mortality rate in that country could decrease even as the mortality gap widens. Alternatively, if child mortality decreases faster among the poor, the health gap could narrow.

To fill this gap in knowledge, the study sought to understand whether developing countries are experiencing a widening or narrowing mortality-rate gap among children under 5 of the poorest and wealthiest families.

To compare wealth status and under-5 child mortality within a country, Bendavid used data from the demographic and health surveys for 1.2 million women living in 929,224 households in 54 developing countries. The women provided information about their children's survival status.

"The people who conduct these surveys, they're intrepid surveyors," said Bendavid, who is also a core faculty member of Stanford Health Policy, which is part of the Freeman Spogli Institute for International Studies. "They reach remote villages up the Congo basin and in the Sahel in Niger, and track the heads of households and women for these in-depth interviews."

The surveys include information about each woman's birth histories, including detailed birth registries documenting millions of children. With this information, Bendavid could estimate the probability of a child dying before reaching age 5 per 1,000 live births.

Tallying household possessions

Determining each household's wealth status was not as straightforward as reviewing annual income and tax returns, which don't exist in the countries involved in the study. "These surveys tally the possessions in the household. What is the floor made of? What is the roof made of?" Bendavid said. "You can get a wide distribution of household possessions that reflects to a large degree the household wealth."

Next, Bendavid developed a three-tier wealth index using the household assets. The three wealth categories were relative -- poorest, middle and wealthiest.

To analyze trends in wealth status and under-5 mortality, Bendavid looked at all developing countries that had completed the surveys in two specific time frames: 2002-07 and 2008-12. The study found that the under-5 mortality rates among the poorest groups had decreased the most rapidly. The average decline was 4.36 deaths each year per 1,000 live births among the poorest, 3.36 among the middle and 2.06 among the wealthiest. Because the poorest group's mortality rate is decreasing more quickly that the other groups, the gap in child-mortality rates is closing.

This is good news, Bendavid said. However, not all countries followed this same trend. In a quarter of the surveys examined by the study, inequality in under-5 mortality increased over time.

Bendavid found that four factors were present in countries with a narrowing child-mortality gap: government effectiveness, rule of law, control of corruption and regulatory quality. He found that the difference in mortality rates was significantly associated with the governance score: Better governance scores were related to greater convergence in mortality rates among the three wealth groups.

Benefits from controlling communicable diseases

Bendavid said the evidence in this study is consistent with gains in controlling communicable diseases, such as malaria, measles, diarrhea and respiratory illnesses, that preferentially affect the poorest. Over the past decade, international health aid organizations have financed interventions for these diseases at a high rate.

"Dr. Bendavid's study is an important contribution to knowledge about child health improvements in the developing world," said Davidson Gwatkin, a senior fellow at the Results for Development Institute and a senior associate at Johns Hopkins Bloomberg School of Public Health. "It makes a persuasive case that these improvements have often begun to benefit the poor even more than the better-off." Gwatkin was not involved in the study.

The study also raises questions about the role of foreign aid institutions in low- and middle-income countries. While the aid efforts are making a difference in child-mortality rates in countries with effective governments, the study seems to show that this is not the case in nations with poor governance, Bendavid said.

"We have the technologies, we have the means, we have the know-how to reduce child mortality dramatically," said Bendavid. "Even for such low-hanging fruit, however, implementation is not always easy. You have to have government that enables basic safety, and the ability to reach poor and rural communities that benefit from these kinds of programs."

INFORMATION:

This work was supported by the National Institute of Allergy and Infectious Diseases (grant KOIAI084582), the Doris Duke Charitable Foundation and the Dr. George Rosenkranz Prize for Health Care Research in Developing Countries.

Information about Stanford's Department of Medicine, which also supported this research, is available at http://medicine.stanford.edu.

The Stanford University School of Medicine consistently ranks among the nation's top medical schools, integrating research, medical education, patient care and community service. For more news about the school, please visit http://med.stanford.edu/school.html. The medical school is part of Stanford Medicine, which includes Stanford Health Care and Lucile Packard Children's Hospital Stanford. For information about all three, please visit http://med.stanford.edu. Print media contact: Becky Bach at (530) 415-0507 (retrout@stanford.edu) Broadcast media contact: Margarita Gallardo at (650) 723-7897 (mjgallardo@stanford.edu)



ELSE PRESS RELEASES FROM THIS DATE:

Mayo Clinic researchers identify first steps in formation of pancreatic cancer

2014-11-10
JACKSONVILLE, Fla. -- Researchers at Mayo Clinic's campus in Jacksonville say they have identified first steps in the origin of pancreatic cancer and that their findings suggest preventive strategies to explore. In an online issue of Cancer Discovery, the scientists described the molecular steps necessary for acinar cells in the pancreas -- the cells that release digestive enzymes -- to become precancerous lesions. Some of these lesions can then morph into cancer. "Pancreatic cancer develops from these lesions, so if we understand how these lesions come about, we may ...

New natural supplement relieves canine arthritis

New natural supplement relieves canine arthritis
2014-11-10
This news release is available in French. VIDEO: Arthritis pain in dogs can be relieved, with no side effects, by a new product based on medicinal plants and dietary supplements that was developed at the University of Montreal's... Click here for more information. Arthritis pain in dogs can be relieved, with no side effects, by a new product based on medicinal plants and dietary ...

MUSE reveals true story behind galactic crash

MUSE reveals true story behind galactic crash
2014-11-10
A team of researchers led by Michele Fumagalli from the Extragalactic Astronomy Group and the Institute for Computational Cosmology at Durham University, were among the first to use ESO's Multi Unit Spectroscopic Explorer (MUSE) instrument on the VLT. Observing ESO 137-001 -- a spiral galaxy 200 million light-years away in the southern constellation of Triangulum Australe (The Southern Triangle) -- they were able to get the best view so far of exactly what is happening to the galaxy as it hurtles into the Norma Cluster. MUSE gives astronomers not just a picture, but provides ...

'Big data' takes root in the world of plant research

Big data takes root in the world of plant research
2014-11-10
Dublin, Ireland, November 9th 2014 - Botanists at Trinity College Dublin have launched a database with information that documents significant 'life events' for nearly 600 plant species across the globe. They clubbed together with like-minded individuals working across five different continents to compile the huge database of plant life histories, for which data have been gathered over a near 50-year span. At a time in which climate change and increasing human populations are rapidly re-shaping plant distributions, the researchers hope their COMPADRE Plant Matrix database ...

So, you think you can clap to the beat?

2014-11-10
Bobbing your head, tapping your heel, or clapping along with the music is a natural response for most people, but what about those who can't keep a beat? Researchers at McGill University and the University of Montreal, have discovered that beat-deafness, though very rare, is a problem not simply of how people feel a pulse or move their bodies, but instead, how people synchronize with sounds they hear. "We examined beat tracking, the ability to find a regular pulse and move with it, in individuals who complained of difficulty following a beat in everyday activities ...

Combination therapy offers quicker, less toxic eradication of hep C in liver transplant patients

2014-11-09
JACKSONVILLE, Fla. -- All patients with hepatitis C who receive a liver transplant will eventually infect their new livers. These transplanted organs then require anti-viral treatment before they become severely damaged. But traditional post-transplant hepatitis C therapy can take up to a year, is potentially toxic and can lead to organ rejection. Now, at the American Association for the Study of Liver Diseases (The Liver Meeting® 2014) in Boston, researchers at Mayo Clinic report that use of two new oral medications post-transplant is safe and beneficial, and requires ...

A/C came standard on armored dinosaur models

2014-11-08
Berlin, Germany (November, 2014) - Sweating, panting, moving to the shade, or taking a dip are all time-honored methods used by animals to cool down. The implicit goal of these adaptations is always to keep the brain from overheating. Now a new study shows that armor-plated dinosaurs (ankylosaurs) had the capacity to modify the temperature of the air they breathed in an exceptional way: by using their long, winding nasal passages as heat transfer devices. Led by paleontologist Jason Bourke, a team of scientists at Ohio University used CT scans to document the anatomy ...

UF researchers discover how to cultivate norovirus in human cells

UF researchers discover how to cultivate norovirus in human cells
2014-11-07
GAINESVILLE, Fla. -- Noroviruses are pernicious intestinal viruses. They cause violent vomiting and diarrhea, and people ill with the virus remain contagious up to three days after they seem to recover. Although a vaccine for these viruses is in clinical trials, there is still no medication to combat them. That's in part because researchers have not been able to culture human noroviruses so they can test potential treatments -- until now, according to a study by University of Florida Health researchers published Friday, Nov. 7 in the journal Science. UF Health researcher ...

Practice makes perfect in cancer surgery

2014-11-07
In a new, in-depth research project, Queen's professors Rob Siemens (Urology) and Christopher Booth (Cancer Care and Epidemiology) investigated what affect higher volume hospitals and surgeons had on the outcomes of patients undergoing a radical cystectomy for bladder cancer in Ontario. Using data provided by the Institute for Clinical Evaluative Sciences (ICES) the investigators studied 2,802 patients who underwent the procedure between 1994 and 2008 in Ontario and found that higher volume hospital and surgeons were associated with less post-operative complications and ...

Preschoolers eat healthy when parents set rules about food, UB study finds

Preschoolers eat healthy when parents set rules about food, UB study finds
2014-11-07
BUFFALO, N.Y. -- Preschoolers whose parents have rules about what their children can and cannot eat have healthier eating habits than those raised without such rules, according to a new study by pediatrics researchers at the University at Buffalo. The study also provides new information on how toddlers' ability to self-regulate, or control, their emotional and behavioral impulses influences their eating habits two years later, depending on the presence or absence of parental food rules. The research is being presented on Nov. 7 at ObesityWeek 2014 in Boston. ObesityWeek ...

LAST 30 PRESS RELEASES:

New perspective highlights urgent need for US physician strike regulations

An eye-opening year of extreme weather and climate

Scientists engineer substrates hostile to bacteria but friendly to cells

New tablet shows promise for the control and elimination of intestinal worms

Project to redesign clinical trials for neurologic conditions for underserved populations funded with $2.9M grant to UTHealth Houston

Depression – discovering faster which treatment will work best for which individual

Breakthrough study reveals unexpected cause of winter ozone pollution

nTIDE January 2025 Jobs Report: Encouraging signs in disability employment: A slow but positive trajectory

Generative AI: Uncovering its environmental and social costs

Lower access to air conditioning may increase need for emergency care for wildfire smoke exposure

Dangerous bacterial biofilms have a natural enemy

Food study launched examining bone health of women 60 years and older

CDC awards $1.25M to engineers retooling mine production and safety

Using AI to uncover hospital patients’ long COVID care needs

$1.9M NIH grant will allow researchers to explore how copper kills bacteria

New fossil discovery sheds light on the early evolution of animal nervous systems

A battle of rafts: How molecular dynamics in CAR T cells explain their cancer-killing behavior

Study shows how plant roots access deeper soils in search of water

Study reveals cost differences between Medicare Advantage and traditional Medicare patients in cancer drugs

‘What is that?’ UCalgary scientists explain white patch that appears near northern lights

How many children use Tik Tok against the rules? Most, study finds

Scientists find out why aphasia patients lose the ability to talk about the past and future

Tickling the nerves: Why crime content is popular

Intelligent fight: AI enhances cervical cancer detection

Breakthrough study reveals the secrets behind cordierite’s anomalous thermal expansion

Patient-reported influence of sociopolitical issues on post-Dobbs vasectomy decisions

Radon exposure and gestational diabetes

EMBARGOED UNTIL 1600 GMT, FRIDAY 10 JANUARY 2025: Northumbria space physicist honoured by Royal Astronomical Society

Medicare rules may reduce prescription steering

Red light linked to lowered risk of blood clots

[Press-News.org] In developing countries, child-mortality rates fell most among poorest families