Field of Science

Why do more children die when Pentecostals are around?

The US has a persistently high infant mortality rate when compared with other wealthy nations. The reasons for this a partly understood - poverty is a major risk factor for childhood death, And it's believed that the high levels of income and racial stratification could be to blame. Problems with health are infrastructure are also thought to contribute.

But could culture be partly to blame? Quite possibly, and one way to find out is to see whether the dominant culture in a region is linked to higher infant mortality. In the USA, religious denomination is an important facet of culture (even better, it's easier to quantify than most other cultural traits).

So John Bartowski, of the University of San Antonio, and colleagues, looked at the number of churches of different denominations in 1,900 counties of the USA and compared this with the number of infant deaths as recorded by the Kids Count programme.

So this was a study of whether the numbers of different kinds of Christians in a given area affected infant mortality, rather than a study of whether individual families with particular beliefs have higher or lower mortality.

It's an ecological study, in other words, looking at the dominant culture of a region. Similar to other recent studies on vaccination rates and trust. Of course, different denominations are present in poor areas compared with wealthy ones so Bartowski statistically controlled for region, black ethnicity, and poverty.

Batowski found that, in general, the more Catholic churches there were in an are the lower infant mortality was. Conversely, more Protestant churches meant higher infant mortality.

But this broad brush conceals a lot of detail. And the beauty of such a rich dataset was that Bartowksi could drill down to look at Protestant denominations in detail.

When he did that, he found that fundamentalist and evangelical churches actually were linked to lower infant mortality. It was mainline Protestant and in particular Pentecostal churches that were linked to higher mortality.

Bartowski speculates that the protective effect of Catholicism "is best explained by the emphasis that Catholicism places on creating a vibrant civic infrastructure, particularly one focused on promoting population health and well-being", while the "pronatalist tendencies of fundamentalism and evangelicalism (advocacy for children and the unborn) contribute to significantly lower infant mortality rates".

And Pentecostals? Well, he suspects that "Pentecostal suspicion of conventional medicine and its reliance instead on faith healing" accounts for the higher infant mortality.

But he does also acknowledge that this study can only be taken as preliminary. What, for example to make of the finding that mainline Protestants are linked to higher infant mortality? Is this a spurious result, perhaps as a result of some other unknown factor? Or is there something deeper going on?
Bartkowski, J., Xu, X., & Garcia, G. (2011). Religion and Infant Mortality in the U.S.: A Preliminary Study of Denominational Variations Religions, 2 (3), 264-276 DOI: 10.3390/rel2030264

Creative Commons License This article by Tom Rees was first published on Epiphenom. It is licensed under Creative Commons.


  1. Fascinating. But in the end, there is "speculation" which I guess if food for the next person who wants to test it.

    Research question:
    child pro: C= Catholic E= Evangelical
    child neglect: M = Mainline P= Pentecostal
    Now there are three areas:
    North = 60% P, 20%C, 20% E, 10% M ==> ? P
    South = 40%P, 25%C, 25%E, 10%M ==> ?P
    East = 40% P, 30 % C, 30%E ==> ?P

    Just curious how the math is done since combinations/tensions and such might play a role.

  2. I was under the impression that a lot of the infant mortality disparities had to do with how such "deaths" are defined and recorded, that what a US hospital considers a live birth (like a 4-month preemie with a heartbeat for a few minutes) is different in other systems. Is that not true?

  3. Sure, but do not forget to look at the variation within the wider context. What context is that? Well, the global context.

    To quote from the study:

    "The United States presents a vexing dilemma with respect to infant mortality.

    Although the U.S. maintains a remarkably high per capita income, its IMRs are disproportionately elevated when compared with other developed nations in the West.

    The infant mortality paradox in the United States continues to generate concern among public health officials and policymakers, many of whom have called for immediate action to reduce the unusually high IMRs in the U.S.

    Rather alarmingly, the most recent efforts to reduce U.S. IMRs have yielded less than stellar results.

    As part of its Healthy People 2010 initiative, the U.S. had been aiming to reduce its IMR to 4.5 infant deaths per 1,000 live births.

    However, most of the first decade of the twenty-first century came and went with little significant change in the U.S. infant mortality rate.

    The U.S. IMR was 6.89 infant deaths per 1,000 live births in 2000 and had dropped only slightly to 6.86 in 2005, and such stagnant results have not been observed since the 1950s.

    Quite tellingly, the U.S. has now revised its 2020 objectives to aim for an IMR of 6.0 per 1,000 live births."

    In the study, the best outcomes were for those counties with high numbers of Roman Catholic churches. But, using Model 2, the improvement was only -0.082. In other words, from 6.89 down to 6.81.

    Finally, I have always objected to infant mortality rates being expressed per 1000. They should be expressed per 100,000 to bring the data into line with most international population data, for example crime rates, including murder and rape.

    Thus, per 100,000, in 2000 the mean average US IMR was 689 infant deaths per 100,00. In Roman Catholic counties it dropped to 681 per 100,000.

    Still far higher than in the UK, in Australia, NZ or other English speaking countries in the OECD.


  4. Tsk, meant to write:

    Thus, per 100,000, in 2000 the mean average US IMR was 689 infant deaths per 100,000.

  5. Hi Sabio, the way they did it was to count the number of each church in each county separately, and relate it to child mortality. So to answer your question, they didn't explicitly look into whether the country had a mix or was more of a monoculture. In the discussion, the authors do actually point out that it would be interesting to look at religious 'fractionalisaion' to see if there was nay link.

  6. Michael, quite possibly right. I don't know much about the Kids Count program, but reading the paper it's clear that their data is pretty patchy. However, assuming that's just noise, the analysis should hold.

  7. Colenso, good point. Yes, the effect they found is trivial in magnitude compared with the size of the problem that the US faces. So turnign everyone Catholic will not do much to reduce infant mortality.

    It would, however, be interesting to see how infant mortality varies across European regions according to dominant religion.


Markup Key:
- <b>bold</b> = bold
- <i>italic</i> = italic
- <a href="">FoS</a> = FoS