US Among Worst in the World for Infant Death

Insurance corporations are not killing kids, and insurance companies are not inherently evil. The system of health-care financing in the United States does permit unnecessary and preventable deaths to occur. There is a difference.

If for-profit insurers are to blame for our nation's high infant mortality rate, then it would stand to reason that low-income parents and children on Medicaid would have superior outcomes to those families who are privately insured. Having worked for years in inner-city neonatal intensive care units, I can assure you that this is not the case.

Poor perinatal outcomes stem from multiple factors including: ever-increasing multiple births due to fertility treatments, increased pregnancy rates in women over age 40, high teen pregnancy rates (both are statistically much riskier than pregnancy in women aged 20-40), unwillingness of many women to access pre-natal care (contrary to popular belief, it is available to women without resources thru virtually any county health department in the U.S.), poor nutrition (WIC programs require the mother to participate in educational programs, which many are unwilling to do), substance abuse, unwillingness to breastfeed (costs nothing and provides healthy nutrition and immunity to infant), lack of financial support from absent fathers, etc.

To place blame for poor perinatal outcomes solely on insurance status is mis-leading, dishonest, and does nothing to advance the cause of improved infant mortality rates.

Here is an intersting bit of info about the rates and why you should not believe them:


WHO defines the standard as follows:

According to the World Health Organization (WHO) definition, all babies showing any signs of life, such as muscle activity, a gasp for breath or a heartbeat, should be included as a live birth. The U.S. strictly follows this definition.

Switzerland:

Switzerland, for instance, doesn't count the deaths of babies shorter than 30 cm, because they are not counted as live births, according to Nicholas Eberstadt, Ph.D., Henry Wendt Scholar in Political Economy at the American Enterprise Institute and formerly a Visiting Fellow at the Harvard University Center for Population and Developmental Studies. So, comparing the 1998 infant mortality rates for Switzerland and the U.S., 4.8 and 7.2 per 1,000 births, respectively, is comparing apples and oranges.

Why doesn't it count babies shorter than 30cm? Because they're most likely to be low-birth weight babies which statistically have a much higher probability of dying. So Switzerland simply counts such babies as "still-births" which don't impact their infant mortality rates.

Read through the explanations found here to understand why the Swiss would try to exclude this category from its statistics. You'll find that the category they exclude is the category with the highest mortality rate.


Other countries are no different. For instance, former easter bloc countries and Russia:

A UNICEF press release noted: "Under the Soviet era definition ... infants who are born at less than 28 weeks, weighing less than 1,000 grams or measuring less than 35 centimeters are not counted as live births if they die within seven days. This Soviet definition still predominates in many [formerly Soviet] CIS countries."

Italy:

Other countries, such as Italy, use different definitions in various parts of their own countries. Eberstadt observes that "underreporting also seems apparent in the proportion of infant deaths different countries report for the first twenty-four hours after birth".

And of course there are many more examples. As an example, look at the statisitcal anomolies here:

In Australia, Canada, and the United States, over one-third of all infant deaths are reported to take place in the first day. ..." In contrast, "Less than one-sixth of France's infant deaths are reported to occur in the first day of life. In Hong Kong, such deaths account for only one-twenty-fifth of all infant deaths."

In other words just about every country reporting these statistics has a different standard for reporting with only the US, apparently, using the strictest.

Since the United States generally uses the WHO definition of live birth, economist John Goodman and others in their 2004 book, "Lives at Risk," conclude, "Taking into account such data-reporting differences, the rates of low-birth-weight babies born in America are about the same as other developed countries in the OECD [Organization for Economic Cooperation and Development]." Likewise, infant mortality rates, adjusted for the distribution of newborns by weight, are about the same.

And, ironically, US statistics are, in a way, a result of our technological advances, advances that have given more marginal babies a chance for survival than they have had at any other time in our history:

American advances in medical treatment now make it possible to save babies who would surely have died only a few decades ago. Until recently, very-low-birth-weight babies, those weighing less than 3 pounds, almost always died. Now some of these babies survive with the help of breathing assistance and other recent inventions.

While such vulnerable babies may live with advanced medical assistance and technology, low-birth-weight babies (weighing less than 5.5 pounds) recently had an infant mortality rate 20 times higher than heavier babies, according to the WHO. And these deaths count as infant deaths even though most would have been counted as stillbirths if they hadn't received the gift of life, however transitory.

Ironically, American doctors' ability to save babies' lives causes higher infant mortality numbers here than would be the case with less advanced medical treatment.

So when you hear all the wailing and gnashing of teeth in the following days, and the anguished questions of "why can't the most advanced country on earth save more of it's babies", take it with a huge grain of salt, please. We now save babies who would never have had a chance at life because of our technology, not despite it.


When and if such reports as this can certify that all reporting nations are using the same standards, then you can begin to take them seriously. Until then, feel free to ignore them. WHO defines the standard as follows:

According to the World Health Organization (WHO) definition, all babies showing any signs of life, such as muscle activity, a gasp for breath or a heartbeat, should be included as a live birth. The U.S. strictly follows this definition.

Switzerland:

Switzerland, for instance, doesn't count the deaths of babies shorter than 30 cm, because they are not counted as live births, according to Nicholas Eberstadt, Ph.D., Henry Wendt Scholar in Political Economy at the American Enterprise Institute and formerly a Visiting Fellow at the Harvard University Center for Population and Developmental Studies. So, comparing the 1998 infant mortality rates for Switzerland and the U.S., 4.8 and 7.2 per 1,000 births, respectively, is comparing apples and oranges.

Why doesn't it count babies shorter than 30cm? Because they're most likely to be low-birth weight babies which statistically have a much higher probability of dying. So Switzerland simply counts such babies as "still-births" which don't impact their infant mortality rates.

Read through the explanations found here to understand why the Swiss would try to exclude this category from its statistics. You'll find that the category they exclude is the category with the highest mortality rate.


Other countries are no different. For instance, former easter bloc countries and Russia:

A UNICEF press release noted: "Under the Soviet era definition ... infants who are born at less than 28 weeks, weighing less than 1,000 grams or measuring less than 35 centimeters are not counted as live births if they die within seven days. This Soviet definition still predominates in many [formerly Soviet] CIS countries."

Italy:

Other countries, such as Italy, use different definitions in various parts of their own countries. Eberstadt observes that "underreporting also seems apparent in the proportion of infant deaths different countries report for the first twenty-four hours after birth".

And of course there are many more examples. As an example, look at the statisitcal anomolies here:

In Australia, Canada, and the United States, over one-third of all infant deaths are reported to take place in the first day. ..." In contrast, "Less than one-sixth of France's infant deaths are reported to occur in the first day of life. In Hong Kong, such deaths account for only one-twenty-fifth of all infant deaths."

In other words just about every country reporting these statistics has a different standard for reporting with only the US, apparently, using the strictest.

Since the United States generally uses the WHO definition of live birth, economist John Goodman and others in their 2004 book, "Lives at Risk," conclude, "Taking into account such data-reporting differences, the rates of low-birth-weight babies born in America are about the same as other developed countries in the OECD [Organization for Economic Cooperation and Development]." Likewise, infant mortality rates, adjusted for the distribution of newborns by weight, are about the same.

And, ironically, US statistics are, in a way, a result of our technological advances, advances that have given more marginal babies a chance for survival than they have had at any other time in our history:

American advances in medical treatment now make it possible to save babies who would surely have died only a few decades ago. Until recently, very-low-birth-weight babies, those weighing less than 3 pounds, almost always died. Now some of these babies survive with the help of breathing assistance and other recent inventions.

While such vulnerable babies may live with advanced medical assistance and technology, low-birth-weight babies (weighing less than 5.5 pounds) recently had an infant mortality rate 20 times higher than heavier babies, according to the WHO. And these deaths count as infant deaths even though most would have been counted as stillbirths if they hadn't received the gift of life, however transitory.

Ironically, American doctors' ability to save babies' lives causes higher infant mortality numbers here than would be the case with less advanced medical treatment.

So when you hear all the wailing and gnashing of teeth in the following days, and the anguished questions of "why can't the most advanced country on earth save more of it's babies", take it with a huge grain of salt, please. We now save babies who would never have had a chance at life because of our technology, not despite it.

When and if such reports as this can certify that all reporting nations are using the same standards, then you can begin to take them seriously. Until then, feel free to ignore them.

http://www.qando.net/details.aspx?Entry=3848

Whether or not the statistics are skewed, I still believe that a lot more can be done to provide better health care for the newest generations.

And while I appreciate that bloggers information.... I think it's somewhat unusual that even though he says where he got the information from he doesn't actually cite any actually sources that we can look directly at the information he gave.

Well I found his source... but that source doesn't give their sources either. Still says WHO, but no exact document.

Newsmax

Is the NIH a good source for you?

http://www.pubmedcentral.nih.gov/art...?artid=1615029

And the info the blogger got came from this source:

Infant Mortality Myths and Mantras

Michael Arnold Glueck, M.D., and Robert J. Cihak, M.D., The Medicine Men
Thursday, March 10, 2005

Thank you! I was not insulting you. It just frustrated me when online bloggers just seem to get information out of their butts sometimes. You have to admit that is very frustrating. It seems like I'm taking a lot of heat for posting this thread, as if I'm the one who actually wrote those articles at CNN and stuff. I was trying to bring a topic up for conversation. People seem to be very heated over this topic though, which is good and conducive to lively debate... but I'm not on anyone's side for this issue. I just wanted to know where that MqO guy got his info.
Thanks again!

I did not take it as an insult.

Actually, it's not NIH but Mathematica, Inc. And the other is Newsmax. 'Nuf said.

But, that said... just follow the money:

http://www.rwjf.org/about/founder.jhtml

Bingo.

I knew I smelled something. Thanks Emmanuel!

I'm not discounting their research as biased, but their funding comes from a source that could be considered to have a vested interest.