Objective This exploratory research project considers the role that the political culture of individual U.S. states may play in determining variation in the countrys infant mortality rate. Specifically, do conventional and/or racialized measures of political culture help explain state-to-state variation, particularly in black infant mortality, as well as the longstanding mortality gap between infants born to black and white women? Conventional measures of political culture in this study include a state's past voting record in presidential elections, as well as how states are categorized under Elazar's (1966) typology of state civic culture (i.e., as moralistic, individualistic or traditionalistic). Racialized measures include, among others, a state's past enactment of anti-miscegenation laws and a preclearance requirement for electoral changes under the Voting Rights Act of 1965 due to past racial discrimination at the ballot box. Data and Methods Data on non-Hispanic black and white IMRs (the dependent variable) and the racial gap for the 59-year period of this study (1950 to 2008) were collected from the Vital Statistics of the United States and generated using CDC WONDER, an online database of the U.S. Centers for Disease Control and Prevention. The primary statistical methodology employed for this study was cross-sectional time-series regression. A total of four time-series models are developed. The first predicts infant mortality rates based on the independent variables introduced. The second predicts variation in two policies, payments to families under the now-defunct Aid to Families with Dependent Children (AFDC) program and Medicaid payments per enrollee, incorporating infant mortality rates as predictors. The third examines infant mortality rates using political culture factors as predictors. The last is a two-stage predictive model of the interaction between the first two models. Results In Model 2, racialized measures of political culture and other political factors are associated with variation in the state, white and black IMRs and the racial gap. Contrary to expectations, both the state and black infant mortality rates and the racial gap are smaller in states that ranked highest on past racial hostility. Meanwhile, the black IMR and the racial gap are exacerbated when states are considered 'tough on crime,' as measured by incarceration rates, degree of felony disenfranchisement, and the black-white racial disparity in imprisonment. Following the two-stage regression model, the measure of past racial hostility is the only political culture variable that remains significant at the p>.05 level, and is associated with a slightly lower black IMR when Medicaid payments are the instrumented variable used. Conclusion Political factors, including measures of political culture, have a role to play in explaining variation in infant mortality rates across the U.S. states. The results of this research have important implications for health policy design and implementation. This research also furthers the growing body of literature on the continuing impact of political culture, race and ethnicity, and the social construction of target groups on health outcomes.
Level of Degree
McFarlane, Deborah R.
First Committee Member (Chair)
Second Committee Member
Third Committee Member
infant mortality, racism, segregation, health, disparities, political culture
Nikora, Rongal D.. "The Political Determinants of Health: The Impact of Political Factors on Black-White Infant Mortality in the United States." (2013). https://digitalrepository.unm.edu/pols_etds/9