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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine the relationship between state size &#40;measured in terms of public spending&#41; and public health indicators in a sample of countries representing all regions of the world and from 1990-2000&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">An ecological study was performed using data on Central Government Spending &#40;CGS&#41; and per capita Gross National Product &#40;GNP&#41; obtained from the International Monetary Fund&#44; and on life expectancy&#44; maternal&#44; and infant mortality&#44; provided by the World Health Organization&#46; A multiple linear regression model was fitted to estimate the effect of CGS on health&#44; which also took into consideration per capita GNP and geographical region&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">CGS varied little over the study period&#44; with convergence around an average of 28&#37;&#44; but within a relatively wide range &#40;7&#46;80-53&#46;0&#37;&#41;&#59; the countries with the strongest economies &#40;according to per capita GNP&#41; had the highest levels of CGS&#46; The influence of this factor was particularly relevant for the infant mortality rate &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;40&#59; beta<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;1&#46;327&#59; EE<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;237&#59; t<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;5&#46;590&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Per capita GNP and geographic location were also associated with variations in health&#59; health indicators tended to be worse for poorer countries in Africa and Asia&#46; In the adjusted model&#44; CGS was statistically significant with regard to infant and maternal mortality rates&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">The study suggests that state size &#40;in terms of public spending&#41; has an important influence upon health and particularly upon mortality&#46; Although it is important to bear in mind the limitations of this study and the reduced time window used&#44; these results should be taken into consideration in the current political and epidemiological debate&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar la relaci&#243;n entre el tama&#241;o del Estado &#40;medido como el gasto p&#250;blico&#41; y los indicadores de salud en una muestra de pa&#237;ses de todas las regiones del mundo&#44; en la d&#233;cada de los noventa&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio ecol&#243;gico a partir de datos sobre gasto gubernamental central &#40;GGC&#41; y producto interior bruto &#40;PIB&#41; per c&#225;pita&#44; obtenidos del Fondo Monetario Internacional&#44; y de esperanza de vida&#44; mortalidad materna y mortalidad infantil&#44; de la Organizaci&#243;n Mundial de la Salud&#46; Se construy&#243; un modelo de regresi&#243;n lineal m&#250;ltiple&#44; para estimar el efecto del GGC sobre salud&#44; y se introdujo tambi&#233;n PIB per c&#225;pita y regi&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El GGC var&#237;a poco durante el per&#237;odo estudiado&#44; convergiendo alrededor de una media del 28&#37;&#44; pero a&#250;n dentro de un amplio rango &#40;7&#44;80-53&#44;0&#37;&#41;&#59; los pa&#237;ses con econom&#237;as altas &#40;seg&#250;n PIB per c&#225;pita&#41; presentan mayor GGC&#46; Su efecto tiene especial importancia sobre la mortalidad infantile &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;40&#59; beta<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;1&#44;327&#59; EE<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;237&#59; t<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;5&#44;590&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Tambi&#233;n el PIB per c&#225;pita y la ubicaci&#243;n regional se asocian a los cambios en salud&#44; coincidiendo con el empeoramiento de los indicadores de salud en algunos pa&#237;ses pobres de &#193;frica y Asia&#46; En el modelo ajustado&#44; el GGC mantiene la asociaci&#243;n estad&#237;stica con mortalidad infantil y mortalidad materna&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">El estudio sugiere un efecto importante del tama&#241;o del Estado sobre la situaci&#243;n de salud&#44; espec&#237;ficamente sobre la mortalidad&#46; Aunque tienen limitaciones&#44; dada la reducida ventana temporal utilizada&#44; estos resultados deben ser considerados en el debate pol&#237;tico y epidemiol&#243;gico actual&#46;</p>"
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