Population-Based Study of Child Mortality (0-4) and Income Inequality in Japan and the Developed world 1989-91 v 2012-14: Any Excess Deaths Between the Most Unequal Countries?

Abstract

Introduction: Parental child `neglect’ is usually linked to parents but can apply to nations using the criteria explicit in UNICEF statement “in the last analysis Child-Mortality-Rates (CMR) indicates how well a nation meets the needs of its children”. Hence under-five (0-4) CMR rates of Japan and twenty Other Developed Countries (ODC) are compared within the context of relative poverty. Method: WHO data yields CMR rates per million (pm), analysed between 1989-91 and 2012-14 to compare Japan against ODC. World Bank Income Inequality data used as a measure of relative poverty. Excess deaths calculated by matching the most unequal Income Inequality country’s CMR with the most equal nation. Results: All countries reduced CMR substantially. The highest CMR was in USA 1383pm, followed by three English-speaking countries. Japan at 597pm was 19th of 21. USA and New Zealand were double Japan’s CMR, whilst twelve ODC had rates 25% higher than Japan. Most unequal Income Inequality USA at 15.9 times, Japan the most equal at 4.5 times. Income Inequality and CMR were strongly correlated (+0.6188 p<0.005). The countries with the lowest Income Inequality, had lowest CMR namely Finland Japan, Norway and Sweden. America not matching Japan’s CMR, meant an average excess of 16,838 US children’s deaths annually. Discussion: The strong statistical association between higher CMR and Income Inequality, suggests that one factor in Japan’s results is the lower social inequality, unlike Canada, New Zealand, the UK and USA. Does Japan’s results indicate cultural factors suggesting Japan is more child orientated than English-speaking countries?