≡ Menu

Inequality Does NOT Explain This Fact

In a new and, I’m certain, well-researched paper, Alice Chen, Emily Oster, and Heidi Williams explore reasons why infant mortality is higher in the U.S. than it is in many other developed countries.  (HT Tyler Cowen)  Here’s the abstract:

The US has a substantial – and poorly understood – infant mortality disadvantage relative to peer countries. We combine comprehensive micro-data on births and infant deaths in the US from 2000 to 2005 with comparable data from Austria and Finland to investigate this disadvantage. Differential reporting of births near the threshold of viability can explain up to 40% of the US infant mortality disadvantage. Worse conditions at birth account for 75% of the remaining gap relative to Finland, but only 30% relative to Austria. Most striking, the US has similar neonatal mortality but a substantial disadvantage in post neonatal mortality. This postneonatal mortality disadvantage is driven almost exclusively by excess inequality in the US: infants born to white, college-educated, married US mothers have similar mortality to advantaged women in Europe. Our results suggest that high mortality in less advantaged groups in the postneonatal period is an important contributor to the US infant mortality disadvantage.

The empirical results strike me as being quite plausible.  So far I’ve only skimmed the paper, but these reported results seem to accurately reflect what is likely the underlying reality.  One take away: while some (40 percent) of the official deficiency of the U.S. on the infant-mortality front is a statistical artifact of different criteria for reporting a birth as ‘live’ or stillborn, a large chunk of the U.S. deficiency is in fact due to worse material conditions for many mothers in the U.S. relative to conditions for mothers in other developed countries.

But this latter problem is almost certainly not caused by “excess inequality in the US”; rather, it’s caused by many more women in the U.S. being poorer than their peers in other developed countries.  Inequality does not imply poverty; poverty is is not a result of inequality.  The two – as John Cochrane so eloquently reminds us – are not at all the same.  It is sloppy thinking (especially for economists) to write as if wealth is a lump of goodies whose total mass is fixed in size.  Many women in America are poor for a variety of different reasons, none of which is that wealthier Americans are wealthier than they are.

Or ask this question: which of the following two alternatives will lower infant-mortality rates in the U.S.?  (1) Make poor American women richer; or (2) confiscate and destroy lots of wealth of relatively rich American women – and thus make these once-richer women poorer – so that there’s greater income equality.  Only if you believe that #(2) will work better than will #(1) to lower infant-mortality rates in the U.S. do you really believe that relatively high infant mortality in the U.S., compared to that in other developed countries, (to quote the abstract above) “is driven almost exclusively by excess inequality.”


Next post:

Previous post: