When calculating data identifying inequalities together with the Ministry of Health in random regions across Brazil in 2012, Barufi, Haddad and Paez found numerous problems: previous expansion of healthcare was ineffective due to its inaccessibility, few socioeconomic improvements have prevented many poor people in Brazil from achieving any social mobility, and finally, without adequate infrastructure, there is little that can be done to reduce the rate of infant mortality (p. 6-8). Relatedly, Narayan Sastry found through his studies on urban and rural infant mortality in 1997 that those community characteristics have a strong impact but do not have a direct effect on infant mortality in Brazil (p. 999-1001). In simpler terms, there are unexamined SDHs that have larger impacts but are not implemented due to lack of study. While his numbers don't overtly infer it, if one community has such a large impact, imagine what preventative care specified for each community could do to influence the IMR for those regions. As presented, infant mortality is clearly a problem, but it is often difficult to precisely identify the major contributing factor. The next section will explain the causes and effects of infant mortality