Socioeconomic and Demographic Correlates of Maternal Mortality: A Cross-National Ecological Study
Abstract
Introduction: The maternal mortality rate(MMR) reflects a nation’s healthcare capacity and socioeconomic development. This study investigates the associations between MMR and various socioeconomic and demographic indicators across 180 countries.
Methods: This ecological study utilizes national-level data from 180 countries(centered on 2019), retrieved from ‘Our World in Data’. Relationships were assessed using Pearson Correlation. Significant variables were included in a backward multiple linear regression model with a threshold of p < 0.20.
Results: Bivariate correlations indicated higher MMR is associated with higher adolescent birth rates(r = 0.734, p < 0.001), children born per woman(r = 0.767, p < 0.001), and income inequality(r = 0.205, p = 0.009). Conversely, MMR correlates negatively with HDI(r= -0.232, p = 0.002), Corruption Perception Index(r= -0.495, p < 0.001), literacy(r= -0.748,p< 0.001), GDP per capita (r= -0.476, p < 0.001), health expenditures(r= -0.520, p < 0.001), skilled birth attendance(r= -0.752, p < 0.001) and women’s political empowerment(r= -0.303, p < 0.001). Multiple regression revealed the number of children per woman was positively associated with MMR(B = 72.218, p < 0.001), whereas skilled birth attendance(B= -3.235, p < 0.001) and literacy (B= -2.101, p = 0.035) showed significant negative associations. Conversely, no statistically significant association was found between the maternal mortality rate and either the Corruption Perceptions Index(p = 0.066) or women’s political empowerment(p = 0.158).
Conclusions: Consequently, macro-level public health strategies prioritizing female educational attainment and addressing factors related to adolescent pregnancies may be important focal points for maternal health policies. Furthermore, the strong association found with skilled birth attendance highlights the potential value of expanding healthcare infrastructure and deploying qualified personnel, particularly in countries facing significant income inequality.
Key messages: • Globally, maternal mortality is significantly positively associated with births per woman, and negatively associated with literacy rates and skilled birth attendance.
• Our model shows skilled birth attendance outweighs general health spending, highlighting allocative efficiency: how health funds are directed matters more than absolute budget size.
Related
- Exploring the spatial nexus between air quality, climate change, and socioeconomic determinants of maternal mortality across the Asia–Pacific region
- Spatial distribution and socioeconomic correlates of anaemia among women of reproductive age in Ghana: a hotspot analysis of the 2022 Demographic and Health Survey
- Machine learning–based ecological prediction of maternal mortality ratio in malaria-endemic Africa
- Large-scale assessment of socioeconomic, demographic and health system structures with US county excess mortality, 2020-2024
- Socioeconomic and demographic determinants of children ever born among ever-married women in Somalia: a multilevel negative binomial regression analysis
BibTeX
@article{guceyu2026socioeconomic,
title = {{Socioeconomic and Demographic Correlates of Maternal Mortality: A Cross-National Ecological Study}},
author = {Z Güceyü and S Karaduman and A Barutçu and B Sazoğlu and İ Çoban and M Ural and ZS Adanır and F Sönmez and ME Özden and S Eser},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.2040},
url = {https://doi.org/10.1093/eurpub/ckag169.2040},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Socioeconomic and Demographic Correlates of Maternal Mortality: A Cross-National Ecological Study
AU - Z Güceyü
AU - S Karaduman
AU - A Barutçu
AU - B Sazoğlu
AU - İ Çoban
AU - M Ural
AU - ZS Adanır
AU - F Sönmez
AU - ME Özden
AU - S Eser
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.2040
UR - https://doi.org/10.1093/eurpub/ckag169.2040
AB - Introduction: The maternal mortality rate(MMR) reflects a nation’s healthcare capacity and socioeconomic development. This study investigates the associations between MMR and various socioeconomic and demographic indicators across 180 countries. Methods: This ecological study utilizes national-level data from 180 countries(centered on 2019), retrieved from ‘Our World in Data’. Relationships were assessed using Pearson Correlation. Significant variables were included in a backward multiple linear regression model with a threshold of p < 0.20. Results: Bivariate correlations indicated higher MMR is associated with higher adolescent birth rates(r = 0.734, p < 0.001), children born per woman(r = 0.767, p < 0.001), and income inequality(r = 0.205, p = 0.009). Conversely, MMR correlates negatively with HDI(r= -0.232, p = 0.002), Corruption Perception Index(r= -0.495, p < 0.001), literacy(r= -0.748,p< 0.001), GDP per capita (r= -0.476, p < 0.001), health expenditures(r= -0.520, p < 0.001), skilled birth attendance(r= -0.752, p < 0.001) and women’s political empowerment(r= -0.303, p < 0.001). Multiple regression revealed the number of children per woman was positively associated with MMR(B = 72.218, p < 0.001), whereas skilled birth attendance(B= -3.235, p < 0.001) and literacy (B= -2.101, p = 0.035) showed significant negative associations. Conversely, no statistically significant association was found between the maternal mortality rate and either the Corruption Perceptions Index(p = 0.066) or women’s political empowerment(p = 0.158). Conclusions: Consequently, macro-level public health strategies prioritizing female educational attainment and addressing factors related to adolescent pregnancies may be important focal points for maternal health policies. Furthermore, the strong association found with skilled birth attendance highlights the potential value of expanding healthcare infrastructure and deploying qualified personnel, particularly in countries facing significant income inequality. Key messages: • Globally, maternal mortality is significantly positively associated with births per woman, and negatively associated with literacy rates and skilled birth attendance. • Our model shows skilled birth attendance outweighs general health spending, highlighting allocative efficiency: how health funds are directed matters more than absolute budget size.
SN - 1101-1262
SN - 1464-360X
ER -