The Impact of Social Determinants of Health, Health Resources, and Environmental Factors on Infant Mortality Rates in Three Gulf Cooperation Council (GCC) Countries.
Moossa Amur Nasser Al Saidi, Rawaa Abubakr Abuelgassim Eltayib, Anak Agung Bagus Wirayuda, Hana Harib Al Sumri, Moon Fai Chan
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Abstract
Worldwide, there has been a notable decline in the infant mortality rate (IMR) in the last 20 years. Regionally, the Gulf Cooperation Council (GCC) countries echo the global trends to a certain extent. This study aims to explore the impact of social determinants of health (SDOH), health resources (HRS), and environmental (ENV) factors on the IMR in Bahrain, Qatar, and Kuwait. It is a retrospective time-series study using yearly data from 1990 to 2022. Partial Least Square Structural Equation Model (PLS-SEM) was utilized to construct an exploratory model of the IMR for each country. The results showed that SDOH, HRS, and ENV factors influenced IMRs in three GCC countries. In all three countries' models, only HRS exerted a direct effect on the IMR (Bahrain: -0.966, 95% CI -0.987 to -0.949; Kuwait: -0.939, 95% CI -0.979 to -0.909; and Qatar: -0.941, 95% CI -0.976 to -0.910). On the other hand, ENV factors and SDOH only influenced the IMR indirectly and negatively. Their beta coefficients ranged from -0.745 to -0.805 for ENV factors and -0.815 to -0.876 for SDOH. This study emphasizes the importance of adopting multi-faceted public health strategies that focus on improving socioeconomic conditions, expanding healthcare resources, and reducing environmental degradation. By adopting these multi-dimensional approaches, Bahrain, Qatar, and Kuwait can continue to progress in reducing IMRs and improving overall public health outcomes.
在过去20年中,全世界的婴儿死亡率显著下降。从区域上看,海合会国家在一定程度上顺应了全球趋势。本研究旨在探讨健康的社会决定因素(SDOH)、健康资源(HRS)和环境(ENV)因素对巴林、卡塔尔和科威特的IMR的影响。这是一项回顾性的时间序列研究,使用了1990年至2022年的年度数据。利用偏最小二乘结构方程模型(PLS-SEM)构建了各国IMR的探索性模型。结果表明,SDOH、HRS和ENV因素影响了三个GCC国家的IMRs。在所有三个国家的模型中,只有HRS对IMR有直接影响(巴林:-0.966,95% CI -0.987至-0.949;科威特:-0.939,95% CI -0.979至-0.909;卡塔尔:-0.941,95% CI -0.976至-0.910)。另一方面,环境因子和SDOH仅间接负向影响IMR。环境因子的贝塔系数为-0.745 ~ -0.805,SDOH的贝塔系数为-0.815 ~ -0.876。这项研究强调了采取多方面的公共卫生战略的重要性,这些战略的重点是改善社会经济条件、扩大医疗资源和减少环境退化。通过采取这些多维方法,巴林、卡塔尔和科威特可以继续在减少药物综合死亡率和改善总体公共卫生成果方面取得进展。