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Clustering Countries to Evaluate Health Outcomes Globally

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Abstract

Clustering countries based on health outcomes is a useful technique for assessing global health disparities. However, data on country-specific indicators of health outcomes are inconsistent across databases from different sources, such as World Bank, WHO, and UNICEF. The new database on under-five child mortality from the Institute for Health Metrics and Evaluation advances information about child mortality by showing both country-level estimates and confidence intervals. We used the new database for child mortality and WHO data for HALE from 160 countries to identify country clusters through model-based clustering techniques. The four clusters in 2000 and six in 2003, within levels of uncertainty, showed nonlinear distributions of health outcomes globally, indicating that no single trajectory for progression is evident. We propose the use of country clusters in further study of societal conditions that contribute to health outcomes and changes over time.

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Acknowledgements

Funding for the research and writing of this paper was provided by grants from the University of Washington School of Nursing Intramural Research Fund and the Natural Sciences and Engineering Research Council of Canada (Grant 327689-06).

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Authors and Affiliations

  1. School of Nursing and Department of Global Health, University of Washington, Seattle, WA, USA

    Sue Thomas Hegyvary

  2. University of Cincinnati College of Nursing, Cincinnatti, Ohio, USA

    Devon M Berry

  3. Department of Mathematics and Statistics, University of Montreal, Montreal, Québec, Canada

    Alejandro Murua

Authors
  1. Sue Thomas Hegyvary
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  2. Devon M Berry
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  3. Alejandro Murua
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Correspondence to Sue Thomas Hegyvary.

Additional information

Country clusters can and should be used to study societal conditions that contribute to changes in health outcomes over time.

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Hegyvary, S., Berry, D. & Murua, A. Clustering Countries to Evaluate Health Outcomes Globally. J Public Health Pol 29, 319–339 (2008). https://doi.org/10.1057/jphp.2008.13

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