others. countries by 2019 gdp (nominal) per capita political modernization perspective, the neo-classical economic theory that scarce goods are most effectively distributed to the market, say that the level of political democracy influences the rate of infant mortality. developing nations with democratic governments tend to be more responsive to public opinion, social movements, and special interest groups for issues like infant mortality. in contrast, non-democratic governments are more interested in corporate issues and less so in health issues. democratic status effects the dependency a nation has towards its economic state via export, investments from multinational corporations and international lending institutions. levels of socioeconomic development and global integration are inversely related to a nation's infant mortality rate. dependency perspective occurs in a global capital system. a nation's internal impact is highly influenced by its position in the global economy and has adverse effects on the survival of children in developing countries. countries can experience disproportionate effects from its trade and stratification within the global system. it aids in the global division of labor, distorting the domestic economy of developing nations. the dependency of developing nations can lead to a reduce rate of economic growth, increase income inequality inter- and intra-national, and adversely affects the wellbeing of a nation's population. a collective cooperation between economic countries plays a role in development policies in the poorer, peripheral, countries of the world. these economic factors present challenges to governments' public health policies. if the nation's ability to raise its own revenues is compromised, governments will lose funding for its health service programs, including services that aim in decreasing infant mortality rates. peripheral countries face higher levels of vulnerability to the possible negative effects of globalization and trade in relation to key countries in the global market. even with a strong economy and economic growth (measured by a country's gross national product), the advances of medical technologies may not be felt by everyone, lending itself to increasing social disparities. in england from 2014 to 2017 a rise in infant mortality was experienced disproportionately in the most deprived local authorities where the previously declining trend in infant mortality was reversed with an additional 24 infant deaths per 100,000 live births per year relative to the previous trend war in policy, there is a lag time between realization of a problem's possible solution and actual implementation of policy solutions. infant mortality rates correlate with war, political unrest, and government corruption. in most cases, war-affected areas will experience a significant increase in infant mortality rates. having a war taking place where a person is planning on having a baby is not only stressful on the pregnant person and foetus, but also has several detrimental effects. however, many other significant factors influence infant mortality rates in war-torn areas. health care systems in developing countries in the midst of war often collapse. attaining basic medical supplies and care becomes increasingly difficult. during the yugoslav wars in the 1990s bosnia experienced a 60% decrease in child immunizations. preventable diseases can quickly become epidemic given the medical conditions during war. many developing countries rely on foreign aid for basic nutrition. transport of aid becomes significantly more difficult in times of war. in most situations the average weight of a population will drop substantially. expecting mothers are affected even more by lack of access to food and water. during the yugoslav wars in bosnia the number of premature babies born increased and the average birth weight decreased. there have been several instances in recent years of systematic rape as a weapon of war. people who become pregnant as a result of war rape face even more significant challenges in bearing a healthy child. studies suggest that people who experience sexual violence before or during pregnancy are more likely to experience infant death in their children. causes of infant mortality in abused pregnant people range from physical side effects of the initial trauma to psychological effects that lead to poor adjustment to society. many people who became pregnant by rape in bosnia were isolated from their hometowns making life after childbirth exponentially more difficult. culture high rates of infant mortality occur in developing countries where financial and material resources are scarce and there is a high tolerance to high number of infant deaths. there are circumstances where a number of developing countries to breed a culture where situations of infant mortality such as favoring male babies over female babies are the norm. in developing countries such as brazil, infant mortality rates are commonly not recorded due to failure to register for death certificates. failure to register is mainly due to the potential loss of time and money and other indirect costs to the family. even with resource opportunities such as the 1973 public registry law 6015, which allowed free registration for low-income families, the requirements to qualify hold back individuals who are not contracted workers. another cultural reason for infant mortality, such as what is happening in ghana, is that "besides the obvious, like rutted roads, there are prejudices against wives or newborns leaving the house." because of this it is making it even more difficult for the pregnant people and newborns to get the treatment that is available to them and that is needed. cultural influences and lifestyle habits in the united states can account for some deaths in infants throughout the years. according to the journal of the american medical association "the post neonatal mortality risk (28 to 364 days) was highest among continental puerto ricans" compared to babies of the non-hispanic race. examples of this include teenage pregnancy, obesity, diabetes and smoking. all are possible causes of premature births, which constitute the second highest cause of infant mortality. ethnic differences experienced in the united states are accompanied by higher prevalence of behavioral risk factors and sociodemographic challenges that each ethnic group faces. male sex favoritism historically, males have had higher infant mortality rates than females. the difference between male and female infant mortality rates have been dependent on environmental, social, and economic conditions. more specifically, males are biologically more vulnerable to infections and conditions associated with prematurity and development. before 1970, the reasons for male infant mortality were due to infections, and chronic degenerative diseases. however, since 1970, certain cultures emphasizing males has led to a decrease in the infant mortality gap between males and females. also, medical advances have resulted in a growing number of male infants surviving at higher rates than females due to the initial high infant mortality rate of males. genetic components results in newborn females being biologically advantaged when it comes to surviving their first birthday. males, biologically, have lower chances of surviving infancy in comparison to female babies. as infant mortality rates saw a decrease on a global scale, the gender most affected by infant mortality changed from males experiences a biological disadvantage, to females facing a societal disadvantage. some developing nations have social and cultural patterns that reflects adult discrimination to favor boys over girls for their future potential to contribute to the household production level. a country's ethnic composition, homogeneous versus heterogeneous, can explain social attitudes and practices. heterogeneous level is a strong predictor in explaining infant mortality. birth spacing map of countries by fertility rate (2020), according to the population reference bureau birth spacing is the time between births. births spaced at least three years apart from one another are associated with the lowest rate of mortality. the longer the interval between births, the lower the risk for having any birthing complications, and infant, childhood and maternal mortality. higher rates of pre-term births, and low birth weight are associated with birth to conception intervals of less than six months and abortion to pregnancy interval of less than six months. shorter intervals between births increase the chances of chronic and general under-nutrition; 57% of pregnant people in 55 developing countries reported birth spaces shorter than three years; 26% report birth spacing of less than two years. only 20% of post-partum people report wanting another birth within two years; however, only 40% are taking necessary steps such as family planning to achieve the birth intervals they want. unplanned pregnancies and birth intervals of less than twenty-four months are known to correlate with low birth weights and delivery complications. also, pregnant parent's who are already small in stature tend to deliver smaller than average babies, perpetuating a cycle of being underweight. prevention and outcomes to reduce infant mortality rates across the world, health practitioners, governments, and non-governmental organizations have worked to create institutions, programs and policies to generate better health outcomes. current efforts focus on development of human resources, strengthening health information systems, health services delivery, etc. improvements in such areas aim to increase regional health systems and aided in efforts to reduce mortality rates. policy reductions in infant mortality are possible in any stage of a country's development. rate reductions are evidence that a country is advancing in human knowledge, social institutions and physical capital. governments can reduce the mortality rates by addressing the combined need for education (such as universal primary education), nutrition, and access to basic maternal and infant health services. a policy focus has the potential to aid those most at risk for infant and childhood mortality allows rural, poor and migrant populations. reducing chances of babies being born at low birth weights and contracting pneumonia can be accomplished by improving air quality. improving hygiene can prevent infant mortality. home-based technology to chlorinate, filter, and solar disinfection for organic water pollution could reduce cases of diarrhea in children by up to 48%. improvements in food supplies and sanitation has been shown to work in the united states' most vulnerable populations, one being african americans. promoting behavioral changes, such as hand washing with soap, can significantly reduce the rate of infant mortality from respiratory and diarrheal diseases. according to unicef, hand washing with soap before eating and after using the toilet can save more lives of children by cutting deaths from diarrhea and acute respiratory infections. focusing on preventing preterm and low birth weight deliveries throughout all populations can help to eliminate cases of infant mortality and decrease health care disparities within communities. in the united states, these two goals have decreased infant mortality rates on a regional population, it has yet to see further progress on a national level. increasing human resources such as physicians, nurses, and other health professionals will increase the number of skilled attendants and the number of people able to give out immunized against diseases such as measles. increasing the number of skilled professionals is negatively correlated with maternal, infant, and childhood mortality. with the addition of one physician per 10,000 people, there is a potential for 7.08 fewer infant deaths per 10,000. in certain parts of the u.s., specific modern programs aim to reduce levels of infant mortality. one such program that aims to reduce infant mortality is the "best babies zone" (bbz) based at the university of california, berkeley. the bbz uses the life course approach to address the structural causes of poor birth outcomes and toxic stress in three u.s. neighborhoods. by employing community-generated solutions, the best babies zone's ultimate goal is to achieve health equity in communities that are disproportionately impacted by infant death. prenatal care and maternal health when a person becomes pregnant, certain steps can help to reduce the chance of complications during the pregnancy. attending regular prenatal care check-ups will help improve the baby's chances of being delivered in safer conditions and surviving. additionally, taking supplementation, including folic acid, can help reduce the chances of birth defects, a leading cause of infant mortality. many countries have instituted mandatory folic acid supplementation in their food supply, which has significantly reduced the occurrence of spina bifida, a birth defect, in newborns. similarly, the fortification of salt with iodine, salt iodization, has helped reduce adverse birth outcomes associated with low iodine levels during pregnancy. abstinence from alcohol can also decrease the chances of harm to the fetus during pregnancy. drinking any amount of alcohol during pregnancy may lead to fetal alcohol spectrum disorders (fasd) or alcohol related birth defects (arbd). tobacco use during pregnancy has also been shown to significantly increase the risk of a preterm or low birth weight birth, both of which are leading causes of infant mortality. pregnant