The health of nations in a global context: trade, global stratification, and infant mortality rates.

Despite the call for a better understanding of macro-level factors that affect population health, social epidemiological research has tended to focus almost exclusively on national-level factors, such as Gross Domestic Product per capita (GDP/c) or levels of social cohesion. Using a world-systems framework to examine cross-national variations in infant mortality, this paper seeks to emphasize the effects of global trade on national-level population health. Rather than viewing national-level health indicators as autonomous from broader global contexts, the study uses network analysis methods to examine the effects of international trade on infant mortality rates. Network data for countries were derived from international data on the trade of capital-intensive commodities in 2000. Using automorphic equivalence to measure the degree to which actors in a network perform similar roles, countries were assigned into one of six world-system blocks, each with its own pattern of trade. These blocks were dummy-coded and tested using ordinary least squares (OLS) regression. A key finding from this analysis is that after controlling for national-level factors, the two blocks with the lowest density in capital-intensive exchange, i.e., the periphery, are significantly and positively associated with national-level infant mortality rates. Results show the effects of peripherality and stratification on population health, and highlight the influence of broader macro-level factors such as trade and globalization on national health.