CDC: U.S. infant mortality drops to 29th

[DesertRat]

Source: UPI

The U.S. infant mortality rate continued to worsen, dropping to 29th in the world in 2004, from 27th in 2000 and 12th in 1960, national health officials say.

A report by the Centers for Disease Control and Prevention's National Center for Health Statistics says the U.S. infant mortality rate -- an indicator of the health of the country -- was 6.78 infant deaths per 1,000 live births in 2004, the latest year data are available for all countries.

In comparison, infant mortality rates were generally lowest -- below 3.5 per 1,000 -- in Sweden, Norway, Finland, Japan, Hong Kong and Singapore. The findings used data collected through the National Vital Statistics System.

The current U.S. infant mortality rate is about 50 percent higher than the national goal of 4.5 infant deaths per 1,000 births, the report says.

Read more: http://www.upi.com/Health_News/2008/10/15/CDC_US_infant_mortality_drops_to_29th/UPI-53901224095727/

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This is a disgrace and a true indicator of our failing health care system.

[sinkingfeeling]

1. You know, "We're Number 29", just doesn't have any ring to it.

[DesertRat]

5. We were 12th in the world in 1960 and now we're 29th!!

This is a horrible indicator of our country's health care system. Many poor women can't afford to see a doctor while pregnant. :(

[FatDave]

10. We're #29! USA! USA!

[Horse with no Name]

2. Despicable.

Amazingly enough...all of those countries with BETTER rates have a national healthcare plan.

On edit...last I looked CUBA had a rate of 5 per 1000. Just.shaking.head.

[WriteDown]

3. One point...

How many infants are being born in Japan these days. 5-10? I'm only half joking.

[eyesroll]

4. I have to wonder, though-- do different countries handle micropremies differently?

Here, a baby born not breathing at 26 weeks will likely receive extreme measures to get her breathing...then she would be considered a live birth even if she died three hours later.

In other countries, would this baby be rescusitated at all? be considered a late-term miscarriage? A stillbirth? How would this affect relative rates?

[DesertRat]

6. That's an interesting point, however

why wouldn't Sweden, Norway, Finland, Japan, Hong Kong and Singapore rescusitate premature babies the same as we do?

[WriteDown]

9. Looks like the problem is caused by the # or preterm births

http://www.sciencedaily.com/releases/2008/07/080729160827.htm

[XemaSab]

22. Yeah, but that's directly related to prenatal care and the health of the mother

:shrug:

[moc]

17. They do. It has more to do with the margins of viability (~500g)

in terms of which infants are declared live births and which are declared fetal deaths. See my post below.

[Tempest]

12. Which raises the question

Why does the U.S. have such a high rate of premature births?

The biggest reason would be the lack of prenatal health care, which is caused by a lack a health care coverage. Something other countries don't have a problem with.

[DesertRat]

18. Exactly right. n/t

[moc]

20. Prenatal care is not a magic bullet, unfortunately. For example, Hispanics (particularly Mex. Am)

have lower rates of PNC utilization but better pregnancy outcomes than African Americans.

It's more complicated than PNC. Personally, I think it's a woman's health issue, with health conceptualized as broadly as possible (psychological health, physical health, economic health, etc.)

[moc]

16. Yes. (I'm a public health academic specializing in maternal and child health)

There are some issues related to declaration of live births at the margins of viability (typically about 500g or about 23-24w; we tend to focus on birth weight instead of gestational age b/c it's more accurate; it's used as a proxy for GA).

The difference is which babies are declared live births vs. which are declared fetal deaths. The official definition of a live birth is any product of conception regardless of GA that shows any sign of life - so that could be a 17w spontaneous miscarriage that shows pulsation of the umbilical cord, for example. In practice, however, doctors often have a lower limit of GA below which they routinely declare a fetal death rather than a live birth. If a baby is declared a fetal death, they are not included in the numerator of the infant mortality rate.

In my class, we discuss a paper that compared cross country rates that looked at perinatal mortality rates (perinatal mortality combines fetal deaths after 28w and infant deaths up to 7 days. For the US data, there was a higher proportion of perinatal deaths that fell into the live birth category whereas in the comparison countries (can't remember which, maybe Norway) there was a higher proportion in the fetal death category. This suggests very small babies may be more likely to be declared a live birth in the U.S. and more likely to be declared a fetal death in Norway. This would inflate the IMR in the U.S. relative to Norway.

They also compared IMRs after excluding births less than 750g, and the disparities between the U.S. and other countries is decreased.

I can provide you with the citation if you're interested.

So, yes, there are some definitional problems which explain some of the between country disparities. However, even within the United States, there are appalling rates of IM and disparities by geography, race/ethnicity, social class etc. There was a recent segment on 20/20 on the IMR in Memphis highlighting how they have 2x the number of infant deaths as murders in that city. We do not do enough to insure the health of infants in this country. Don't get me started on "right to life" hypocrites who don't understand the importance of insuring healthy babies.

Hope this helps. Sorry if I rambled.

[fascisthunter]

7. Republicans will make us last if they get their way

so much for being "pro-life"

[harmonicon]

8. birth and death are all that matter to them, not life

It's what's become of Christianity to certain elements. The only important points in the Bible (except for the bits in Leviticus about how genocide is great, and homosexuality isn't so hot) are Jesus's birth, and his death - the actual life thing where he did and said stuff is totally ignored.

[fascisthunter]

11. yup... I know.... I studied the Bible

Most of it anyway.... they have hijacked the Bible, the word christianity and now use it for purely political and authoritarian reasons. If anything, these nutjobs think they are god.

[aquart]

13. We're killing our children with this rampant warring greed.

[corkhead]

14. Imagine where we would be if we didn't have "The World's Best Healthcare"TM

[Peace Patriot]

15. And guess who's better than the U.S.? Cuba--best infant health care (indicator of

general health care) in Latin America, and second only to Canada in the western hemisphere.

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Cuba's infant mortality rate is lowest in Latin America
4 January 2007

Havana.– In 2006, Cuba had the lowest infant mortality rate in its history and of all Latin America, putting it in second place behind Canada for the Americas as a whole, according to a health ministry report.

Cuba's infant mortality rate was 5.3 deaths per 1,000 births in 2006, compared to 5.8 per 1,000 in 2005, making it "the leader in Latin America" in the category, said the report quoted in the official newspaper Granma.

http://www.dominicantoday.com/dr/this-and-that/2007/1/4/21172/Cubasinfant-mortality-rate-is-lowest-in-Latin-America

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Cuba Reduces Infant Mortality Rate to 5.3
Saturday, January 05, 2008

Havana, Jan 5 (Prensa Latina) Cuba concluded 2007 with an infant mortality rate of 5.3 per 1,000 live births, a number which leads all of Latin America, the Caribbean and is considerably below the US rate of 6.0.

http://cubajournal.blogspot.com/2008/01/cuba-reduces-infant-mortality-rate-to.html

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Health Care? Ask Cuba
By NICHOLAS D. KRISTOF

Published: January 12, 2005

Here's a wrenching fact: If the U.S. had an infant mortality rate as good as Cuba's, we would save an additional 2,212 American babies a year.

Yes, Cuba's. Babies are less likely to survive in America, with a health care system that we think is the best in the world, than in impoverished and autocratic Cuba. According to the latest C.I.A. World Factbook, Cuba is one of 41 countries that have better infant mortality rates than the U.S.

http://www.nytimes.com/2005/01/12/opinion/12kris.html

----------------------------

I notice that recent reports in the Corpo/fascist 'news' monopolies tend to leave Cuba out of the story. (The NYT column, above, that I found in a Google search, is 2005.) The truth is that, as to health care, socialism is best, communism is next best and predatory capitalism means poor health care for most people, with many unable to afford health care at all, and with the U.S. tumbling down the charts to rank with the most predatory capitalist, fascist and most poorly run governments in the world. Reaganism and Bushwhackism have done this to us. We used to rank way up there with only the most developed socialist countries (the Scandinavians) ahead of us.

Irony: The Cuban revolution overthrew what was arguably the worst "banana republic" on earth--the Batista regime (whose adherents fled to Miami and became Republicans), and Castro's Cuba (an attempt to right the wrongs of the Batista regime) became the most hated and reviled government on earth, by U.S. politicians and Corpo/fascists, despite Cuba's obvious advances in human welfare. Cuba has such a good health care system that it now exports doctors to other countries, for instance, to staff new medical clinics for the poor in some of the many South American countries that have elected leftist governments over the last decade (and whose rightwing governments had utterly neglected health care for the poor, including neglecting medical education for doctors and other health care professionals, and other basics of a decent society, such as street lighting, flood control and low cost housing in poor areas).

Cuba has universal health care, with a stress on preventive medicine, and FREE medical education for all qualified students. To me that latter is very important. A doctor's first motivation should be compassion, and if you saddle young doctors with hundreds of thousands of dollars in debt coming out of medical school, your health care system is going to fail for most people. They may have been motivated by compassion in the first year of their educations; by the end of their educations, this humongous debt is their overriding reality. Do the math. General practitioners--family doctors--fall out of the system. Young doctors can't afford to work in health clinics for the poor. All doctors are tempted to do deals with Big Pharma and other money-making propositions, and to develop high end medical practices that serve the wealthiest people. Their first priority has to be servicing a huge debt. Whatever their good instincts may have been, they are almost all forced to put money first--and this ultimately corrodes and degrades the health care system, with the poor suffering the most (little or no health care) and the middle class increasingly falling into crippling debt due to skyrocketing medical costs, and greedy blood-sucking "middle men"--the insurance companies and credit card usurers.

Cuba goes to the other extreme--all doctors making only modest salaries (in a system with many social supports commonly shared), and no "middle men"--but the "other extreme" illustrates what medicine has traditionally been all about: compassion. Not yachts and second mansions. The medical profession is founded on an ancient Greek oath to put the patient first. Predatory capitalism fundamentally assaults that oath. The Cuban system fosters it. And the socialized medicine of Scandinavia and Europe falls somewhere in between.

It's disgustingly ironical that the insurance and other Corpo lobbies tout the myth of a "personal physician" to stop all political impetus toward socialized medicine here, while THEY are the intervenors between patient and doctor. THEY are the ghouls who profit from illness--by selectively cutting out the sickest people, and those most in need of health care, from coverage, and profiteering against all with increasing premiums, drug price gouging and all they other abuses we've seen.

In Cuba, the state provides health care to everyone, and is in fact NOT a "middle man" because everyone is entitled to care. The burden of human illness is shared, and spread out, so that it does not fall on the most vulnerable--the people who are ill.

Although all the new leftist governments of South American are NOT following the Cuban economic model--they have mixed socialist/capitalist economies (more like Europe)--and strong democracies, in which people can still own property and become rich if they play by the rules (pay their taxes, obey the laws)--they are influenced by Cuba's health care system, and the best of them are opting for universal health care. And, at some point, they, too, are going to suprass the U.S. in health care statistics and other measures of a good society--while we, well, it's hard to say where we are headed, but it's looks, at the present moment, like we are headed toward becoming the biggest "banana republic" on earth.

[moc]

19. I got into an argument with a Cuban American at a party recently about this.

As many descendents of Cuban exiles, she wanted to believe that "Castro bad=Cuban health bad". When I told her that Cuban IMR was lower than US IMR, she accused me of lying. Probably not something I should have gotten into at a party. She was a physician too, just a grossly misinformed physician.

[depakid]

21. Out of curiousity what's your general impression on rising IMR in the states?

(I know, probably calls for a thousand words or none)

[moc]

23. I can give you my theory (in less than 1000 words, I promise!)

There are two components of infant mortality - the birth weight distribution (i.e., the proportion of infants born into each birth weight group) and birth weight specific mortality (the probability of mortality for infants in a specific birth weight category). In the last 40 years, virtually ALL of the reductions in IMR have been the result of reductions in birth weight specific mortality - the introduction of infant resuscitation, the introduction of artificial surfactant, etc. In other words, we've done a great job of saving little babies, but we haven't made any improvements in the numbers of small babies to begin with. The preterm birth rate has increased dramatically in the last decade or so.

My theory as to why the IMR is creeping up is that we have reached the limit of our ability to reduce infant deaths by reducing bw-specific mortality, and that the increasing preterm birth rate is starting to "bump up against" IMRs and starting to push them upward. Any future reductions in IMR are solely dependent on us figuring out how to keep babies safely inside their mothers longer. For very tiny babies, every week of added gestation is associated with huge reductions in mortality.

[Quantess]

24. Last time I saw the infant mortality rate, USA was one slot above Croatia

That was in 1996.

[xchrom]

25. recommend -- the glory days behind us? nt

[burrowowl]

26. Reukes are against abortion however

They just let the infant mortality rate take care of what they don't want as births. That way it is "god's" choice.