President Obama’s Affordable Care Act and former president Bill Clinton’s Health Security Act, which never passed, are two of the most recent public health plans pushed by Democratic presidents. Republicans, on the other hand, might not be so steadfast in securing the public’s health. At least, that’s what critics are taking from a new study that found infant death rates were higher during Republican presidents’ terms.

“Infant mortality rates in the U.S. exceed those in all other developed countries and in many less developed countries, suggesting political factors may contribute,” researchers of the study wrote in the International Journal of Epidemiology. Indeed, U.S. infant mortality rates are high, currently standing at about 25,000 deaths each year. Major causes of infant death include birth defects, preterm births, sudden infant death syndrome, and maternal complications, according to the Centers for Disease Control and Prevention (CDC).

Because of these high rates, the researchers looked at infant mortality during nine presidencies — four Democratic and five Republican — spanning between 1965 and 2010. Although infant mortality dropped 75 percent during the overall time, the researchers noticed that, when looking at short-term changes, infants were three percent more likely to die during Republican presidencies. These findings held even after they accounted for factors like unemployment rates, smoking rates, abortion rates, and education and income. They also noted that the effects were proportional among both blacks and whites, although blacks experience more than twice the infant death rates as whites, “implying substantially larger absolute effects for blacks.”

The Controversy

Although there could be other factors shaping these results, the researchers said that they were “struck by the consistency of the association we have uncovered,” and that the association could have arisen from “conditions existing for mothers and infants during Democratic vs. Republican administrations,” according to LiveScience.

“It may be that Republicans are more likely to view health disparities as inevitable, whether due to market forces or as a matter of personal responsibility to be addressed through individual health behaviors, not by government,” the researchers speculated, according to The Washington Post. “Democrats, on the other hand, may be more likely to view health disparities as a preventable social problem about which something should be done via government intervention. Although this is an oversimplified rendering of differences in the ideological traditions, it suggests one type of reason why one might expect Republican and Democratic presidents to affect population health differently.”

Perhaps, in an effort to avoid political bickering, the researchers said that other factors may have played a part in public health and that a president’s party doesn’t always affect legislation. But the study was met with its fair share of critics. An editorial published soon after the study, written by Democrat Ralph Catalano, argued that the methods the researchers used to get their results were flawed and that they should have used a different method. He also argued that the study didn’t prove cause and effect. “You have to tell me what the connection is,” he told LiveScience. “If they say it’s changing health care, let’s take a look and see.”

The researchers countered, saying that his method would not have been appropriate, partially on the basis that it used some mortality data from Canada, and that they had used various methods, which all ended up with the same results. They also defended their intent to study policy effects on public health saying: “To the extent that human-made public, social, and health policies and programs are powerful determinants of health, epidemiology is a social, and inherently political science.” With that said, they argued that there’s a difference between learning of these results, and saying that a “causal mechanism ‘does not exist’” rather than “acknowledging we ‘do not know.’” They said that these findings were the first step, and that elaborating on these associations will help determine whether there’s a cause, and how.

Source: Rodriguez J, Bound J, Geronimus A. US infant mortality and the President’s party. International Journal of Epidemiology. 2013.