摘要：Objectives . We investigated the association between average income or deprivation and infant mortality rate across neighborhoods of 4 world cities. Methods . Using a maximum likelihood negative binomial regression model that controls for births, we analyzed data for 1988–1992 and 1993–1997. Results . In Manhattan, for both periods, we found an association (.05% significance level) between income and infant mortality. In Tokyo, for both periods, and in Paris and London for period 1, we found none (5% significance level). For period 2, the association just missed statistical significance for Paris, whereas for London it was significant (5% level). Conclusions . In stark contrast to Tokyo, Paris, and London, the association of income and infant mortality rate was strongly evident in Manhattan. The nationwide infant mortality rate in the United States is notoriously high in comparison with the national rates of other wealthy nations belonging to the Organization for Economic Cooperation and Development (OECD). 1, 2 This problem is often attributed to bias in reporting differences among nations. 3, 4 However, no one would argue that reporting bias constitutes a complete explanation. The higher US infant mortality rate may also be attributable to our more heterogeneous population and our lack of universal health care coverage (leading to inadequate access to services, including prenatal care for pregnant mothers). More generally, the higher US rate may result from socioeconomic conditions (e.g., the relatively high level of poverty and the extent of income inequality in the United States compared with other OECD nations). 5 We departed from more conventional comparative analyses of national health statistics. We took as our units of analysis large administrative neighborhoods in New York, London, Paris, and Tokyo. These world cities have heterogeneous populations (albeit much less so in Tokyo) and increasing income disparities between rich and poor. Within each city, we investigated the relationship between infant mortality rate and an income-related variable across its neighborhoods.
