Correlation between national income, HIV/AIDS and political status and mortalities in African countries

Andoh, S.Y.; Umezaki, M.; Nakamura, K.; Kizuki, M.; Takano, T.

doi:10.1016/j.puhe.2006.04.008

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Volume 120, Issue 7 , Pages 624-633, July 2006

Correlation between national income, HIV/AIDS and political status and mortalities in African countries

S.Y. Andoh
- Health Promotion, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8519, Japan
M. Umezaki
- International Health and Medicine, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
- Department of Human Ecology, Graduate School of Medecine, University of Tokyo, Tokyo, Japan
K. Nakamura
- International Health and Medicine, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
M. Kizuki
- Health Promotion, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8519, Japan
T. Takano
- Health Promotion, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8519, Japan
- Corresponding author. Tel.: +81 3 5803 5190; fax: +81 3 3818 7176.

Received 15 April 2005; received in revised form 16 January 2006; accepted 5 April 2006.

Summary

Objectives

To investigate associations between mortalities in African countries and problems that emerged in Africa in the 1990s (reduction of national income, HIV/AIDS and political instability) by adjusting for the influences of development, sanitation and education.

Methods

We compiled country-level indicators of mortalities, national net income (the reduction of national income by the debt), infection rate of HIV/AIDS, political instability, demography, education, sanitation and infrastructure, from 1990 to 2000 of all African countries (n=53). To extract major factors from indicators of the latter four categories, we carried out principal component analysis. We used multiple regression analysis to examine the associations between mortality indicators and national net income per capita, infection rate of HIV/AIDS, and political instability by adjusting the influence of other possible mortality determinants.

Results

Mean of infant mortality per 1000 live births (IMR); maternal mortality per 100,000 live birth (MMR); adult female mortality per 1000 population (AMRF); adult male mortality per 1000 population (AMRM); and life expectancy at birth (LE) in 2000 were 83, 733, 381, 435, and 51, respectively. Three factors were identified as major influences on development: education, sanitation and infrastructure. National net income per capita showed independent negative associations with MMR and AMRF, and a positive association with LE. Infection rate of HIV/AIDS was independently positively associated with AMRM and AMRF, and negatively associated with LE in 2000. Political instability score was independently positively associated with MMR.

Conclusions

National net income per capita, HIV/AIDS and political status were predictors of mortality indicators in African countries. This study provided evidence for supporting health policies that take economic and political stability into account.

Keywords: Mortality, National income, Indebtedness, HIV/AIDS, Political instability, Africa