US Among Worst in the World for Infant Death

True, I agree. And I agree with what everyone has seemed to mutually agree on about this topic. I just couldn't put my finger on what seemed to be "strange" to me. That however, as you have said, does not discount the research that they've completed. I think this is one of those topics that can never be conductively completed because there are just too many variable involved. And you figure with the population differences the economic differences and the over all health differences for each nation, to say that the US is amongst the worst in the world just seems incomprehensible, especially; when you take into account (what someone said earlier) that these articles were based only on industrialized nations. Therefore the topic itself is skewed and very hard to represent in a accurate and truthful light.

http://www.savethechildren.net/allia...007-05-08.html

http://www.savethechildren.net/media...2007-final.pdf

http://www.savethechildren.net/media...alrep_2006.pdf

That report seems to be the source, from what I can tell.

http://www.cdc.gov/omhd/AMH/factsheets/infant.htm#1

http://www.cdc.gov/nchs/fastats/infant_health.htm

IMO, dismissing this with the argument that other countries don't include low birth weight/pre-term infants in their statistics doesn't fly.

According to the cdc statistics, less than 17% of infant deaths are attributed to low birth weight and short gestation.
Subtracting the number of deaths attributed to low birth weight and short gestation, that comes to 23,294. Which equals ~ 5.7 deaths per 1000 live births. And that still puts the US far below other countries.

http://www.un.org/esa/population/pub...lights_rev.pdf

(table A18 and A19)

As far as rationalizing [not referring to you, btw] that these mortality rates are somehow skewed because of all those darned poor people--- well, sorry. The numbers are what they are.

You know, I really don't think it matters where we "rank". I think we as a world should do what we can to improve the quality of life and the chances of baby smith to see his/her second birthday...

Exactly

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.

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.

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.

It's in the links above.