OBJECTIVES A previous study reported that increased state and local government expenditures were associated with decreased infant mortality rates (IMRs). However, reported estimates of the association between expenditures and IMR represented the degree to which the association changed each year, not the main effect. We reproduced the original results, reporting this main effect and replicated the analysis using improved methodology and updated data. METHODS For the reproduction analysis, we used methods and data identical to the original study: A publicly-posted, state-level data set of expenditures from 2000 to 2014 US Census Bureau survey data linked to 2-year lagged IMR data with a random intercept model including an interaction between time and expenditures. For the replication analysis, we added 5 years of data and adjusted for fixed state differences and inflation. RESULTS In the reproduction, the main effects of total, environmental, and educational expenditures on IMR were much larger than the interaction effects previously reported as the main effects. For example, a 1-SD increase in per-capita total expenditures was associated with a reduction of 0.35 infant deaths per 1000 live births instead of 0.02 deaths per 1000 live births originally reported. In the updated replication, the main effects were generally even larger (eg, -0.51 deaths per 1000 per SD increase in total expenditures). Increased total expenditures were associated with absolute but not relative reductions in Black-white IMR gaps. CONCLUSIONS State and local government expenditures are associated with greater reductions in IMR than previously reported, underscoring the importance of continued public investment.

中文翻译：

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州和地方政府支出和婴儿死亡率。


目的 先前的一项研究报告称，州和地方政府支出的增加与婴儿死亡率 （IMR） 的降低有关。然而，报告的支出与 IMR 之间关联的估计值代表了关联每年变化的程度，而不是主要影响。我们重现了原始结果，报告了这一主要效应，并使用改进的方法和更新的数据复制了分析。方法 对于繁殖分析，我们使用了与原始研究相同的方法和数据：公开发布的 2000 年至 2014 年美国人口普查局调查数据的州级支出数据集与 2 年滞后的 IMR 数据相关联，具有随机截距模型，包括时间和支出之间的交互。对于重复分析，我们添加了 5 年的数据，并针对固定状态差异和通货膨胀进行了调整。结果 在繁殖中，总、环境和教育支出对 IMR 的主效应远大于先前报道的主效应。例如，人均总支出每增加 1-SD，每 1000 名活产婴儿死亡人数减少 0.35 人，而不是最初报告的每 1000 名活产婴儿死亡人数减少 0.02 人。在更新的副本中，主要影响通常更大（例如，总支出每增加 1000 个 SD，死亡人数为 -0.51）。总支出的增加与黑人和白人 IMR 差距的绝对减少相关，但与相对减少无关。结论 州和地方政府支出与 IMR 的降低幅度比以前报告的更大相关，这凸显了持续公共投资的重要性。