US Among Worst in the World for Infant Death - page 3

"In 2004, the most recent year for which statistics are available, roughly seven babies died for every 1,000 live births before reaching their first birthday, the Centers for Disease Control and... Read More

  1. by   EmmaG
    Quote from Jolie
    To what does the CDC attribute the other 83% of infant deaths in the U.S.? It seems that focusing on those factors would have the greatest impact on our infant mortality rates.
    I pointed out the low birth wt and gestation because it was said that is what skewed the rates for us. Clearly it didn't to the extent that was being argued. But I understand what you're saying.
  2. by   EmmaG
    http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_14.pdf

    http://www.hhs.gov/news/press/2002pres/infant.html

    PROMOTING ACCESS TO PRENATAL AND INFANT CARE
    Early and continuous prenatal care helps identify conditions and behavior that can result in low birthweight babies, such as smoking, drug and alcohol abuse, inadequate weight gain during pregnancy and repeat pregnancy in six months or less. HHS supports many programs to improve access to prenatal and infant care, including:
    Healthy Start. The Healthy Start program, administered by the Health Resources and Services Administration (HRSA), works to expand the availability and accessibility of prenatal health care in more than 100 communities nationwide with higher-than-average infant mortality rates. Designed to meet community needs, the projects include outreach, case management, health education and community consortia. www.healthystart.net/. --->
    Medicaid and SCHIP. Medicaid is a state and federal partnership that provides access to prenatal care for eligible mothers and health coverage for millions of infants from low-income families. States can expand eligibility and services for pregnant women and their infants. As part of such expansions, states have streamlined application procedures to encourage early and continuous access to prenatal care and added coverage for parenting education. Families are encouraged and offered assistance to obtain well-child screenings that can identify and treat health problems. In addition, about 4.6 million children who otherwise would not have access to health care were covered under the State Children's Health Insurance Program (SCHIP) during fiscal year 2001 - a 38 percent increase from the previous year. HHS also has proposed allowing states to provide SCHIP coverage for prenatal care.
    Toll-free prenatal care hotline. HHS supports a toll-free hotline to assist pregnant women and others seeking information on prenatal care, including referrals to local clinics and physicians. Assistance is available in English at 1-800-311-BABY (2229) and in Spanish at 1-800-504-7081.
    Childhood immunization initiative. HHS efforts to promote and provide childhood immunizations have helped to increase immunization rates among children, with 90 percent or more of America's toddlers receiving the most critical doses of vaccines for children by age 2. With childhood vaccination levels in the United States at or near an all-time high, disease and death from preventable diseases are at or near record lows.
    PROMOTING HEALTHY CHOICES TO REDUCE MORTALITY RISKS
    As part of its broader efforts to reduce infant mortality, HHS agencies support a wide range of outreach and education efforts aimed at reducing behavior that increases the risks of infant mortality. These efforts include:
    Folic acid campaign. HHS participates in the National Folic Acid Campaign to promote the use of folic acid to prevent serious birth defects such as spina bifida and anencephaly. The goal of the campaign is to educate all women who could possibly become pregnant to consume 400 micrograms (400 mcg) of folic acid daily from vitamin supplements and/or fortified foods, in addition to eating certain foods with folic acid. The campaign involves the Centers for Disease Control and Prevention (CDC), the March of Dimes and the National Council on Folic Acid. More information is available at www.cdc.gov/ncbddd/folicacid.
    "Back to Sleep" campaign. The public-private "Back to Sleep" campaign educates parents and caregivers that babies who sleep on their backs have a lower risk of SIDS. The 1999 National Institute of Child Health and Human Development (NICHD) household survey found that 85 percent of infants were sleeping either on their sides or backs. The number of SIDS deaths has decreased from 4,891 in 1992 to 2,648 in 1999, a 46 percent decrease. The campaign is led by HHS and co-sponsored by other organizations, including the American Academy of Pediatrics, the SIDS Alliance and the Association of SIDS and Infant Mortality Programs. Information about the campaign is available at www.nichd.nih.gov.
    Reducing mother-to-child HIV transmission. HHS provides information to women and their physicians on HIV testing and treatment with zidovudine (AZT) and other anti-viral drugs, as well as obstetrical approaches, to reduce transmission of HIV from mother to child. HHS guidelines and educational materials are available at www.aidsinfo.nih.gov/.
    Maternal and Child Health Services Block Grant (Title V). HRSA provides block grants to states to develop service systems to meet critical challenges in maternal and child health, including reducing infant mortality. These state efforts are developed with careful attention to Health Status Indicators and National Performance Measures, among them those that emphasize the importance of adequate prenatal care in improving the health of pregnant women and reducing infant mortality.
    Reducing teen pregnancy. Infants born to teenage mothers are at higher risk of being born low birthweight babies and have a higher mortality rate. HHS directly funds teen pregnancy prevention programs in more than 2,200 communities - about 47 percent of all communities nationwide. By focusing on abstinence and personal responsibility, HHS hopes to help young people make the choices that will lead to a successful future. More information on HHS' teen pregnancy prevention efforts is available at www.hhs.gov/news/press/2002pres/teenpreg.html .
    Healthy People 2010. Reducing infant mortality is one of the major goals of Healthy People 2010, the nation's prevention initiative developed by HHS in partnership with the private sector, universities, state and local health departments and community groups. Healthy People's framework relies on science and consensus to guide efforts to promote health and prevent disease. The initiative includes 22 measurable health objectives specific to risk factors for infant mortality and more than 100 related objectives on issues such as cigarette smoking. More information on Healthy People 2010 is available at www.health.gov/healthypeople.
    PROMOTING RESEARCH TO REDUCE INFANT MORTALITY
    HHS supports a wide range of medical research to prevent and treat birth defects, premature birth, SIDS and other life-threatening conditions. For example:
    • The wider use of antenatal corticosteroid treatments to prevent premature labor and promote lung maturation -- clinical practice endorsed by the National Institutes of Health (NIH) Consensus Development Conference -- as reduced deaths of premature infants and lowered the incidence of respiratory distress syndrome and internal hemorrhage in the infant.
    • Treatment with surfactant, discovered and developed through research supported by the National Institute of Child Health and Human Development (NICHD) and the National Heart, Lung and Blood Institute (NHLBI), has also reduced deaths of premature infants from respiratory distress syndrome.
    • NICHD-supported research has shown that treatment of a common condition known as bacterial vaginosis with specific antibiotics can reduce the risk of a premature delivery. Clinical trials are in progress to determine which precise treatment would be most effective.
    • NHLBI, with input from NICHD, is developing an enhanced research agenda to address key issues regarding hypertensive disorders of pregnancy, such as preclampsia -- an abnormal increase in blood pressure during pregnancy that affects 5 percent to 8 percent of pregnancies and contributes to maternal, fetal and infant morbidity and mortality.
    • The CDC is examining sociocultural, behavioral and environmental factors, including stress and social support, related to preterm births among African-American women in Harlem, N.Y., and Los Angeles, Calif.
  3. by   Jolie
    I'm really not trying to nitpick, I am genuinely curious as to what the CDC attributes 83% of our infant deaths, if not prematurity, and/or low birth weight.

    The above links mention mostly initiatives that are aimed at the principal causes (and treatments) of prematurity and LBW: inadequate prenatal care, teen pregnancy, short interval between pregnancies, substance abuse, low socio-economic status, maternal complications such as PIH and diabetes, and more effective care of the preemie including prevention of chronic lung disease, IVH, and infections.

    The only initiatives I see that are related to infant care per se are those aimed at SIDS prevention, AIDS transmission, folic-acid related neural tube defects and immunization rates (which stand at 90%). It is hard for me to fathom that infant deaths from SIDS, AIDS, neural tube defects and preventable childhood diseases occur at 4 times the rate of deaths from complications of prematurity.
  4. by   EmmaG
    Quote from Jolie
    I'm really not trying to nitpick, I am genuinely curious as to what the CDC attributes 83% of our infant deaths, if not prematurity, and/or low birth weight.
    It's in the links above.

    The 10 leading causes of infant death were:

    Congenital malformations, deformations, and chromosomal abnormalities (congenital malformations)

    Disorders relating to short gestation and low birth weight,
    not elsewhere classified (low birthweight)

    Sudden infant death syndrome (SIDS)

    Newborn affected by maternal complications of pregnancy
    (maternal complications)

    Accidents (unintentional injuries)

    Newborn affected by complications of placenta, cord, and
    membranes (cord and placental complications)

    Respiratory distress of newborn

    Bacterial sepsis of newborn

    Neonatal hemorrhage

    Diseases of the circulatory system (circulatory diseases)
  5. by   Kyrshamarks
    The Robert Wood Foundation is one of the worlds largest private donators of grants. ANYONE can apply for thier grant. No where does it state that you have to have certain political beliefs or your research has to go a certain way. I have assisted with medical studies that were funded by that group.
  6. by   ginger58
    We've been at the bottom of he heap for decades. Why might this be? Socioeconomic class access to care, lots of druggies, OBs not able to recognize preterm labor--yes, more stress here and faster pace of life. So sad in a country like this.
  7. by   EmmaG
    Quote from Kyrshamarks
    The Robert Wood Foundation is one of the worlds largest private donators of grants. ANYONE can apply for thier grant. No where does it state that you have to have certain political beliefs or your research has to go a certain way. I have assisted with medical studies that were funded by that group.
    Didn't say otherwise.

    But it can be argued that receiving funding from a foundation connected to "the world's most comprehensive and broadly based manufacturer of health care products, as well as a provider of related services, for the consumer, pharmaceutical, and medical devices and diagnostics markets", and where only 18% of that business is retail-consumer driven, they could be perceived to have a vested interest in the results of said research.

    http://www.jnj.com/our_company/family/index.htm
  8. by   Jolie
    Quote from Emmanuel Goldstein
    It's in the links above.
    Thanks for the information. I didn't see it in the links.

    With the exception of SIDS and accidents, newborn deaths related to these causes would tend to occur in the first month of life, which is consistent with statistics and my experience in actual practice.

    While death rates due to some of these causes (prematurity, low birth weight, maternal complications, RDS, sepsis, cardiac defects related to diabetes) could be improved by better and more consistent prenatal care, some would not (congenital abnormalities, chromosomal abnormalities).
  9. by   EmmaG
    Quote from Jolie
    Thanks for the information. I didn't see it in the links.

    With the exception of SIDS and accidents, newborn deaths related to these causes would tend to occur in the first month of life, which is consistent with statistics and my experience in actual practice.

    While death rates due to some of these causes (prematurity, low birth weight, maternal complications, RDS, sepsis, cardiac defects related to diabetes) could be improved by better and more consistent prenatal care, some would not (congenital abnormalities, chromosomal abnormalities).
    I think there was mention of the neonatal period (0-28 days), but it may include up to one year. I thought infant mortality was calculated on how many survive their first year of life. I'm not sure; I'll have to look when I can stomach reading it again.

    I read through some of the links to the data on the cdc sites. It was quite sobering... like alois said, regardless of our "standing", it is simply unacceptable. The rate of African American infant mortality is horrendous. Without going back to check the links again, I believe it was nearly 14/1000. Good Lord.
    Last edit by EmmaG on Nov 14, '07
  10. by   x_coastie
    this thread has little to do with actual information, and much to do with the all too common "lets bash america and everything american" mentality.

    it is amazing that so many american nurses are so quick to jump on the "america is bad" and "american health care is bad" bandwagon. a simple google search on the subject is all that is needed to show that this belief is wrong. as kyrshamarks (thank you) pointed out by multiple links, american health care is not the worst in the world, in fact it is the best in the world ( in patient care) when some one takes a objective look and not fall in to the "i hate america" trap. read this article on the the who's hidden agenda to see what i am talking about; http://www.cchconline.org/publications/whoart.php3 .

    sorry if this seems like a rant, but threads like this are filled with bias and misinformation.

  11. by   EmmaG
    And then there are those who refuse to admit that maybe--- just maybe--- we aren't "the best" and there is definite room for improvement.

    Perhaps you should continue reading the thread...


    p.s. This thread doesn't say that the US healthcare is "the worst in the world".
  12. by   x_coastie
    Quote from emmanuel goldstein
    and then there are those who refuse to admit that maybe--- just maybe--- we aren't "the best" and there is definite room for improvement.

    perhaps you should continue reading the thread...


    p.s. this thread doesn't say that the us healthcare is "the worst in the world".
    edited by author
    my bad i guess i miss understood the title of the thread

    i apologize for the rudeness, but this thread is just a deceiving (most countries calculate viable births differently than the us), pro-universal health care thread that has little actual information value ( like most threads of this type.)
    Last edit by x_coastie on Nov 26, '07 : Reason: unneeded rudeness
  13. by   Alois Wolf
    Quote from x_coastie
    "us among worst in the world for infant death"

    that was a little childish...


    any btw, again... that was not my choice of title. that was the title of the article which i had linked to. and for that matter, you're argument is non-sequitur. the title does not say america's health care is the worst, it says that it is worst in the world for infant death which the majority of us in this thread has disagreed with to some degree or another. as far as america being the best, that's an empty pointless argument. anyone who says that they are the best at anything must feel that there is no room for improvement, and while our standards of care are not too shabby compared to some other nations we could still use improvement. no one is perfect, nothing is designed to be perfect and everything, including this "perfect" america which you say we are bashing, is not exempt from that fact. so before you start flaming us and spamming us with your gaudy and tacky bold lettering, please consider the fact that not everyone thinks the same way that you do about the world and while i will defend your right to say whatever you please under the constitution of this rather fine and beautiful country, your argument has no base and is sophomoric at best.
    i do not hate america or true patriots. i hate those who refuse to look at facts and educate themselves with both sides of the issue. you rely on your emotions too strongly for your attack to hold any merit and for that matter to have any effect on our opinions that have been clearly stated in this thread. this topic was open for discussion and was never meant (and i have said this earlier in the thread) to reflect anyone's sole opinion on the matter. if you should be angry at anyone it should be those who carelessly titled the attached articles in the way they did. and before you say that it wasn't meant for us directly then consider for a moment, if you will that the articles were written by non-nurses for the general public (the original ones in the op that is).

    peace be to you and yours.

    ps what goldstein had suggested you to do was read the thread not make assumptions from the title alone.


    pps i apologize for my harshness, but in the future i'm sure everyone would appreciate it if you didn't try to prove your point by presenting information in a false light. (i.e. the title of this thread). though i must reiterate, even as the op i do not agree with the title it was by no means an attempt for me to express an opinion that i think that america is in anyway a "bad" country... but i also must reiterate that it isn't a perfect country either. even if you are the best at something, in opinion (which is all it really is) there is always room for improvement. please be more careful in the words you choose.
    Last edit by Alois Wolf on Nov 16, '07 : Reason: Grammar/Spelling

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