WUNRN
WUNRN CALLS FOR CONTINUED UPDATING OF INFANT & MATERNAL MORTALITY RESEARCH & DATA PLUS CORE CAUSES
USA Centers for Disease Control & Prevention
http://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm
The death of a baby before his or her first
birthday is called infant mortality. The infant mortality rate is an estimate of the number of infant
deaths for every 1,000 live births. This rate is often used as an indicator to
measure the health and well-being of a nation, because factors affecting the
health of entire populations can also impact the mortality rate of infants.
There are obvious differences in infant mortality by age, race, and ethnicity;
for instance, the mortality rate for non-Hispanic black infants is more than
twice that of non-Hispanic white infants.
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USA LAGS BEHIND OTHER WEALTHY NATIONS ON INFANT MORTALITY – AMERICAN GROWING INCOME GAP REFLECTS IN INFANT MORTALITY
By Christopher
Ingraham – September 29, 2014
"There is tremendous inequality in the
US, with lower education groups, unmarried, & African-American women having
much higher infant mortality rates,"
The United States has a
higher infant mortality rate than any of the other 27 wealthy countries,
according to a new report from the Centers for
Disease Control. A baby born in the U.S. is nearly three times
as likely to die during her first year of life as one born in Finland or Japan.
That same American baby is about twice as likely to die in her first year as a
Spanish or Korean one.
Despite healthcare spending
levels that are significantly higher than any other country in the world,
a baby born in the U.S. is less likely to see his first birthday than one
born in Hungary, Poland or Slovakia. Or in Belarus…Or in Cuba, for that matter.
The U.S. rate of 6.1
infant deaths per 1,000 live births masks considerable state-level variation. If Alabama were a country,
its rate of 8.7 infant deaths per 1,000 would place it slightly behind Lebanon in the world rankings.
Mississippi, with its 9.6 deaths, would be somewhere between Botswana and
Bahrain.
We're the wealthiest
nation in the world. How did we end up like this?
New research, in a draft paper from Alice Chen of the University of South
California, Emily Oster of the University of Chicago, and Heidi Williams of
MIT, offers up some clues. They note that the infant mortality gap between the
U.S. and other wealthy nations has been persistent -- and is poorly understood.
One factor, according to
the paper: "Extremely preterm births recorded in some places may be
considered a miscarriage or still birth in other countries. Since survival
before 22 weeks or under 500 grams is very rare, categorizing these births as
live births will inflate reported infant mortality rates (which are
reported as a share of live births)."
Oster and her colleagues
found that this reporting difference accounts for up to 40 percent of the U.S.
infant mortality disadvantage relative to Austria and Finland. This is somewhat
heartening.
But what about that other
60 percent?
"Most striking,"
they write, "the US has similar neonatal mortality but a substantial
disadvantage in postneonatal mortality" compared to Austria and Finland.
In other words, mortality rates among infants in their first days and weeks of
life are similar across all three countries. But as
infants get older, a mortality gap opens between the U.S. and the other
countries, and widens considerably. You can see this clearly in the chart
below.
Digging deeper into these
numbers, Oster and her colleagues found that the higher U.S. mortality rates
are due "entirely, or almost entirely, to high mortality among less
advantaged groups." To put it bluntly, babies born to poor moms in the
U.S. are significantly more likely to die in their first year than babies born
to wealthier moms.
In fact, infant
mortality rates among wealthy Americans are similar to the mortality rates
among wealthy Fins and Austrians. The difference is that in Finland and
Austria, poor babies are nearly as likely to survive their first years as
wealthy ones. In the U.S. - land of opportunity - that is starkly not the case:
"there is tremendous inequality in the US, with lower education
groups, unmarried and African-American women having much higher
infant mortality rates," the authors conclude.
One way of understanding
these numbers is by noting that most American babies, regardless of socio-economic
status, are born in hospitals. And while in the hospital, American infants
receive exceedingly good care - our neo-natal intensive care units are among
the best in the world. This may explain why mortality rates in the first few
weeks of life are similar in the U.S., Finland and Austria.
But the differences arise
after infants are sent home. Poor American families have considerably
less access to quality healthcare as their wealthier counterparts.
One measure of the
Affordable Care Act's success, then, will be whether it leads to
improvements in the infant mortality rate. Oster and her colleagues note that
Obamacare contains provisions to expand post-natal home nurse visits,
which are fairly common in Europe.
Research like this drives
home the notion that economic debates in this country - about inequality,
poverty, healthcare - aren't just policy abstractions. There are real lives at
stake.