Neoliberal economic policies and infant and child mortality: Simulation analysis of a Chilean paradox

The paradox of deteriorating living standards for the poorest coexisting with declining infant and child mortality rates during the 1970s is explained by a simultaneous model where these rates and the birth rate are endogenous. Partial- and general-equilibrium results conflict; some apparently satisfactory policy tools have counterproductive impacts; action on small groups of selected policy variables is more effective than overall economic and social welfare expansion; and policy effects differ according to social class. The role of midwife visits, average real earnings, and cheap energy for poor urban households are emphasized. Perversely, high unemployment also contributed to the actual mortality decline during the period.