Partisan Control of U.S. State Governments: Politics as a Social Determinant of Infant Health.

Abstract

State policies and programs affect population health; yet, little is known about the connections between health and the political institutions and actors that prescribe and execute those policies and programs. The 2-way fixed-effects regression models were fitted to data from the National Center for Health Statistics, 1969-2014, to estimate logged infant mortality rate differentials between Republican- and non-Republican‒controlled state legislatures. These data were used in 2020 to hypothesize that net of trend, fluctuations in infant mortality rates-overall and by race-correlate with the party that controls state legislatures (the Lower House, the Upper House, and Congress). Findings show that state infant and postneonatal mortality rates are substantively higher under Republican-controlled state legislatures than under non-Republican‒controlled ones. The effect size is larger for postneonatal than for neonatal mortality. Findings suggest that effects may be greater for Black than for White infants, although the race-specific results are estimated imprecisely. The governor's party shows no substantive impacts on infant mortality rates net of party control of the Lower House. Findings support the proposition that the social determinants of health are constructed, at least in part, by the power vested in governments.