Letter: Infant mortality and medical welfare

Sir: There is a danger that a fallacy, if repeated often enough, will become accepted wisdom. K. G. Taylor (letter, 31 August), echoing the earlier Office of Health Economics report, states that infant mortality is 'a key indicator of medical welfare'.

Among OECD countries there is no association between infant mortality and the percentage of GDP spent on health. There is considerable evidence that socioeconomic and environmental factors are much more important than medical care in determining health status, as reflected in indices such as the infant mortality rate.

There may be arguments for increasing the amount of health care funding in this country, but it should not be thought that this will necessarily reduce the infant mortality rate to that of other industrialised countries. Broader development, with social policies based on equity, poverty alleviation, environmental improvement and education are the way

forward.

Yours faithfully,

MARTIN McKEE

PAUL GARNER

London School of Hygiene

and Tropical Medicine

London, WC1

1 September