Objective: The United Nations Human Development Index (HDI) is a composite index of life expectancy, literacy, and per capita gross domestic product that measures the socioeconomic development of a country. We estimated infant and maternal mortality rates in the world and assessed how well the HDI and its individual components predicted infant and maternal mortality rates for individual countries.
Materials: Data on mortality rates and values for HDI components were obtained from the United Nations and the World Bank.
Results: For the 1987 to 1990 period, approximately 9 million infant deaths and 349,000 maternal deaths occurred in the world annually, yielding global infant and maternal mortality rates of 67 per 1000 and 250 per 100,000 live births, respectively. HDI is a powerful predictor of both infant and maternal mortality rates. It accounts for 85% to 92% of the variation in infant mortality rates, and 82% to 85% of the variation in maternal mortality rates among countries. Each component of HDI is also strongly correlated with both infant and maternal mortality rates (significance of all values for r, p < 0.001), and eliminating life expectancy from HDI does not decrease significantly the predictive power of HDI for infant or maternal mortality rates.
Conclusion: HDI is not only a useful measure for socioeconomic development, but also a powerful predictor of infant and maternal mortality rates for individual countries.
PIP: The UN Human Development Index (HDI), a composite index of life expectancy, literacy, and per capita gross domestic product, provides a measure of a country's level of socioeconomic development. An analysis of mortality data obtained from the United Nations and the World Bank indicated that the HDI is, in addition, a powerful predictor of infant and maternal mortality rates. The 1990 infant mortality rate in the 78 countries for which data were available ranged from 5/1000 live births in Japan to 143/1000 live births in Bhutan and Gambia; the maternal mortality rate ranged from 3/100,000 live births in Finland to 1500/100,000 live births in Nepal. The HDI accounted for 85-92% of the variance in infant mortality rates and 82-85% of that in maternal mortality. Although life expectancy tended to be the HDI component with the strongest predictive power, especially for infant mortality, the explanatory power of the index did not decrease significantly even when this component was excluded. If infant and mortality rates in developed countries in 1987-90 had prevailed worldwide, 8 million infant and 340,000 maternal deaths would have been averted each year.