US Among Worst in the World for Infant Death

  1. "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 Prevention says. That was down from about 26 in 1960."
    -Yahoo News


    "...In industrialized nations deaths were most likely to result from babies being born too small or too early, while in the developing world about half of newborn deaths were from infection, tetanus and diarrhea....

    ...The research also found that poorer mothers with less education were at a significantly higher risk of early delivery. The study added that in general lower educational attainment was associated with higher newborn mortality.
    Tinker said some nations ranked high in part because they offer free health services for pregnant women and babies, while the United States suffers from disparities in access to health care...."
    -CNN


    I found this to be quite shoking and I was suprised by what I read. It's so very dissapointing, especially because of the healthcare availability issue. Any thoughts?
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  2. 45 Comments

  3. by   HM2VikingRN
    But what may at first seem like a remarkable achievement is actually not impressive when statistics show the United States ranking near the bottom among industrialized nations in infant mortality, theA.P.reports. A 2006 Save the Children report listed the U.S. ahead of only Latvia, and tied with Hungary, Malta, Poland and Slovakia near the bottom of the list.
    Why aren't infant death rates even lower? Racial and economic disparities, the wire service reports. For example, CDC statistics show that babies born to black mothers in the United States die at two-and-a-half times the rate of babies whose mothers are white, theA.P.reports.
    http://www.washingtonpost.com/wp-dyn...111100475.html
  4. by   Altra
    Quote from Alois Wolf
    I found this to be quite shoking and I was suprised by what I read. It's so very dissapointing, especially because of the healthcare availability issue. Any thoughts?
    My first thought is the disparity between the title you have chosen for the thread "US Among Worst in the World ..." vs. the data you quote which labels the US as near the bottom of a list of industrialized nations.

    The US statistics reflect issues in certain sectors of the population with a lack of access to care, undereducation and maternal health conditions including diabetes, obesity and drug use.

    I wonder to what degree the U.S. infant mortality statistics are skewed by aggressive medical intervention with babies delivered at 22-28 weeks, with mixed outcomes.

    Also, I think it's important to note the actual differences in infant mortality among the industrialized countries listed in the table which accompanies the article (statistical table produced by Save the Children). The table ranges from Japan's less than 2 per 1,000 live births to Latvia's 6 per 1,000. The US comes in at 5, though as HM2Viking points out, this data varies considerably by race in the US.
    Last edit by Altra on Nov 12, '07
  5. by   TheCommuter
    I think that SES (socioeconomic status) is a significant factor in the poor rankings of the US regarding infant death.

    Although the US is the economic superpower and a very moneyed nation, we still possess numerous segments of the population that are poor, undereducated, do not realize the value of prenatal care, and are far less likely to change detrimental lifestyle habits during pregnancy. These segments include inner city women, immigrants, poor women from the Appalachian region, and a few others.

    Many low SES women arrive at the emergency room to deliver their infants without ever having received any prenatal care. I know of a poor young woman with three children who asked, "Why don't I ever deliver 7-pound babies? My children have all been 4 and 5 pounds!" She also smoked 2 packs per day during the pregnancy. A great deal of these women lack health insurance, and are less likely to see the doctor when their blood pressure spikes upward, or when vaginal bleeding is noticed early in the pregnancy.
  6. by   pickledpepperRN
    I agree that "worst in the world" is inaccurate.
    In fairness to the original post this forum is titled "News" and that was the title of the articles in newspapers and web sites not the creation of the OP.


    http://abcnews.go.com/Health/wireStory?id=3848450

    http://www.physorg.com/news113939643.html

    http://news.yahoo.com/s/ap/20071111/...est_us_picture
  7. by   Alois Wolf
    Quote from MLOS
    My first thought is the disparity between the title you have chosen for the thread "US Among Worst in the World ..." vs. the data you quote which labels the US as near the bottom of a list of industrialized nations.

    The US statistics reflect issues in certain sectors of the population with a lack of access to care, undereducation and maternal health conditions including diabetes, obesity and drug use.

    I wonder to what degree the U.S. infant mortality statistics are skewed by aggressive medical intervention with babies delivered at 22-28 weeks, with mixed outcomes.

    Also, I think it's important to note the actual differences in infant mortality among the industrialized countries listed in the table which accompanies the article (statistical table produced by Save the Children). The table ranges from Japan's less than 2 per 1,000 live births to Latvia's 6 per 1,000. The US comes in at 5, though as HM2Viking points out, this data varies considerably by race in the US.
    Erm well if you read the articles you would have assesed that I in fact did not "choose" the title, that I had taken it from the Yahoo headline... so yeah. But I do agree with what you're saying...
    Last edit by Alois Wolf on Nov 12, '07
  8. by   sjt9721
    Quote from MLOS
    I wonder to what degree the U.S. infant mortality statistics are skewed by aggressive medical intervention with babies delivered at 22-28 weeks, with mixed outcomes.

    :yeahthat:
  9. by   lizzyj
    i hate to be melodramatic, but that's pretty much what it comes down to.[/b]

    [http://www.msnbc.msn.com/id/21714869/ at least according to today's report finding that] america is last among industrialized democracies in terms of infant mortality. because our healthcare system is set up to guarantee billions of dollars of profit to unnecessary insurance corporations, kids born here are more likely to die than they are in countries with guaranteed healthcare through the single-payer model.

    ...cross-posted at the [http://www.guaranteedhealthcare.org/blog national nurses organizing committee/california nurses association's] breakroom blog, as we organize for guaranteed healthcare on the single-payer model.

    [http://www.msnbc.msn.com/id/21655131/ one place this hits hard is memphis,] along with other cities with predominantly african-american populations. african-american kids are two and a half times more likely than white kids to die in infancy. racism starts early, i guess.

    this is the context in which rudy giuliani stated his big lie about cancer patients being better of in america than europe. he's been proven wrong but refuses to apologize. [http://commentisfree.guardian.co.uk/...ncer_myth.html
    ezra klein takes a look.]

    one of the real flashpoints for the battle over healthcare is in kentucky and west virginia, where [http://www.kentucky.com/news/state/story/226717.html nurses across the country are traveling to support their striking colleagues] in the appalachian regional healthcare system. arh is trying to bump up their profits by slashing the number of nurses caring for patients. profits over patients indeed.

    in california, we're working hard to stop a fake reform plan that includes an individual mandate, e.g. a requirement that every person purchase expensive, wasteful insurance products.

    fortunately,[http://www.sacbee.com/walters/story/483856.html public opinion is turning against this nasty little brew] cooked up by arnold schwarzenegger and aided by the capitulation of some key democrats who are also on the insurance industry (and hospital industry) payroll to the tune of hundreds of thousands of dollars.

    if we can break it here, we can break it anywhere!
  10. by   TheCommuter
    There's already a thread started about this issue: http://allnurses.com/forums/f195/us-...th-261137.html
  11. by   sirI
    Threads merged.
  12. by   Multicollinearity
    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.
  13. by   Jolie
    Quote from lizzyj
    i hate to be melodramatic, but that's pretty much what it comes down to.[/b]

    [http://www.msnbc.msn.com/id/21714869/ at least according to today's report finding that] america is last among industrialized democracies in terms of infant mortality. because our healthcare system is set up to guarantee billions of dollars of profit to unnecessary insurance corporations, kids born here are more likely to die than they are in countries with guaranteed healthcare through the single-payer model.
    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.
  14. by   Kyrshamarks
    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

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