Infant mortality and economic development: the case of Malaysia

Household data from the Malaysian Family Life Survey are used to assess the roles of mortality correlates in explaining the inverse relationship between the infant mortality rate (IMR) and socioeconomic development. Increases in mothers' education and improvements in water and sanitation are the most important changes that accompany regional and temporal development and contribute to the inverse relationship between the IMR and development. One concomitant of development--reduced breastfeeding--has kept the relationship from being even stronger. However, these variables explain only a small portion of the difference in the IMR between more and less developed areas and times. For the regional comparison, differences in the ethnic composition of the poorest and other states of Malaysia explain the remainder of the difference. The appendix explicitly examines which relationships have changed with development and finds that the beneficial effect of supplemented breastfeeding in promoting survival became weaker with development.