Widening the lens on child health

evidence of inequalities in child mortality across a range of causes. Their findings provide another sobering reminder that the cliché of New Zealand being ‘a great place to bring up kids ’ holds true for some, but it cannot be presumed to be the case for all. The authors admit that theirs is an analysis focussing on ‘proximal risk factors ’ such as acquisition of diseases and the experience of severe injuries. The results bear further witness to the gradients of life chances experienced across Western countries. The steepest gradients in the Shaw paper belong to ‘non road traffic injury ’ and ‘other’. These categories carry the potential to apportion blame through the so-called ‘accident ’ of a child acting, or being acted upon, in a certain way.2 Wisely, however, the authors point to ‘distal mechanisms ’ such as policies on transport, income, and food as having ultimate influence over the grim occurrences that precipitate child deaths. Elsewhere, researchers have grappled with untangling these complex distal relations between human development and what Hertzman3 terms ‘the social/economic/psychosocial conjunction’. Clearly, a study reliant on census and mortality records cannot examine the relative importance of ‘distal