{"id":2801,"date":"2006-10-06T07:33:30","date_gmt":"2006-10-06T14:33:30","guid":{"rendered":"http:\/\/www.amptoons.com\/blog\/archives\/2006\/10\/06\/the-uss-poor-performance-in-infant-mortality-is-not-a-measurement-error\/"},"modified":"2006-10-06T07:33:30","modified_gmt":"2006-10-06T14:33:30","slug":"the-uss-poor-performance-in-infant-mortality-is-not-a-measurement-error","status":"publish","type":"post","link":"https:\/\/amptoons.com\/blog\/?p=2801","title":{"rendered":"The US's Poor Performance In Infant Mortality Is Not A Measurement Error"},"content":{"rendered":"

A recent US News & World Report<\/em><\/a> column by Dr. Bernadine Healy claims:<\/p>\n

Just last week, the Commonwealth Fund issued a score card that flunked U.S. health system performance with newborns. The reason? Our current infant mortality rate of 6.4 per 1,000 live births is high compared with the 3.2 to 3.6 per 1,000 estimated for the three top-scoring countries in the world-Iceland, Finland, and Japan. It’s also higher than the 6 deaths per 1,000 for the European community as a whole. Before putting on the hair shirt, let’s take a look behind these numbers as these comparisons have serious flaws. They also convey little about why we lose nearly 28,000 babies a year, a starting point if we want to bring universal health to our nation’s cradles.<\/p>\n

First, it’s shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don’t reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates.<\/p><\/blockquote>\n

Here’s a graph I made back in May<\/a>:<\/p>\n

\"Graph:<\/p>\n

Even when stillbirth deaths are included, the US is still doing significantly worse than countries credited with low infant morality rates. It is therefore impossible that the US’s poor standing is caused entirely by the exclusion of stillborn children from infant mortality statistics (although this exclusion may be a contributing factor). The US’s terrible track record, compared to other wealthy countries, is an atrocity, and one that shouldn’t be swept under the rug.<\/p>\n

Dr. Healy does claim that the US’s high infant mortality rate is linked to our greater “ethnic and cultural diversity.” I have to wonder about that – is there any evidence that minorities in other first world countries do far worse in infant mortality (and maternal mortality) than majority groups? Or that they do as badly as some minority groups here in the US do?<\/p>\n

But it’s true that when it comes to infant and maternal mortality, the US is effectively two nations. As I wrote in 2003<\/a>, how likely you are to die in birth – or childbirth – in the U.S. depends on race. According to the CDC<\/a>, the U.S. infant mortality rate for whites is 5.7 per 1000, a rate comparable to Switzerland or Australia. The U.S. infant mortality rate for blacks is 14 per 1000, a rate comparable to Uruguay and Bulgaria. The differences in maternal mortality rates<\/a> are even more stark – 5.5 per 100,000 for whites, compared to 23.3 per 100,000 for blacks. This means that as far as maternal mortality is concerned, American whites have nearly the best health care in the world – better than Sweden’s – while American blacks might as well be living in Bulgaria or Saudi Arabia. (I’m using 1995 World Health Organization data, available in word format here<\/a>, to make this comparison).<\/p>\n

Bottom line: If we judge by infant and maternal deaths, blacks in the US effectively live in the third world, rather than in the first world. (See this post<\/a> for some information about infant mortality among other demographic groups in the US.)<\/p>\n

Curtsy to Mick at Newsbadger<\/a> (who seems to have entirely bought the US News & World Report<\/em> spin, alas).<\/p>\n","protected":false},"excerpt":{"rendered":"

A recent US News & World Report column by Dr. Bernadine Healy claims: Just last week, the Commonwealth Fund issued a score card that flunked U.S. health system performance with newborns. The reason? Our current infant mortality rate of 6.4 … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,93],"tags":[],"class_list":["post-2801","post","type-post","status-publish","format-standard","hentry","category-abortion-reproductive-rights","category-race-racism-and-related-issues"],"_links":{"self":[{"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/2801","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2801"}],"version-history":[{"count":0,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/2801\/revisions"}],"wp:attachment":[{"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2801"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2801"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2801"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}