Posted on 08/24/2009 11:31:02 AM PDT by neverdem
Lack of access to health care does not explain America's infant mortality rate
The American medical system has the latest technology, the greatest variety of new drugs, and unparalleled resources. But anyone who thinks we're getting something great for our dollars inevitably encounters a two-word rebuke: infant mortality.
The United States is the richest nation on Earth, but it comes in 29th in the world in survival rates among babies. This mediocre ranking is supposed to make an irrefutable case for health care reform. If we cared enough to insure everyone, we are told, we would soon rise to the health standards of other modern nations. It's just a matter of getting over our weird resistance to a bigger government role in medical care.
But not every health issue is a health care issue. The reason boxers are unusually prone to concussions is not that they lack medical insurance. Doctors may treat head injuries, but it's a lot easier to prevent them. Absent prevention, we shouldn't blame the medical industry for punch-drunk fighters.
Like life expectancy (the subject of a previous column), infant mortality is a function of many factors. The more you look at the problem, the less it seems to be correctable by a big new federal role in medical insurance—and, in fact, the less it seems to be mainly a medical issue at all.
No one denies the problem. Our infant mortality rate is double that of Japan or Sweden. But we live different lives, on average, than people in those places. We suffer more obesity (about 10 times as much as the Japanese), and we have more births to teenagers (seven times more than the Swedes). Nearly 40 percent of American babies are born to unwed mothers.
Factors like these are linked to low birth weight in babies, which is a dangerous thing. In a 2007 study for the National Bureau of Economic Research, economists June O'Neill and Dave O'Neill noted that "a multitude of behaviors unrelated to the health care system such as substance abuse, smoking and obesity" are connected "to the low birth weight and preterm births that underlie the infant death syndrome."
Nicholas Eberstadt, a scholar at the American Enterprise Institute in Washington, also attributes the gap largely to conduct. Comparing white Americans to Norwegians in his 1995 book, The Tyranny of Numbers, Eberstadt concluded that "white America's higher rates of infant mortality are explained not by poverty (as conventionally construed) or by medical care but rather by the habits, actions, and indeed lifestyles of a critical portion of its parents." Whites are not unique in those types of behavior.
African-American babies are far more likely to die than white ones, which is often taken as evidence that poverty and lack of health insurance are to blame. That's entirely plausible until you notice another racial/ethnic gap: Hispanics of Mexican or Central or South American ancestry not only do consistently better than blacks on infant mortality, they do better than whites. Social disadvantage doesn't explain very much.
Nor does access to prenatal care, as the health care critique implies. It used to be assumed that if you assured that pregnant low-income women could see a physician, their infants would do much better. Not necessarily.
When New York expanded access to prenatal care under Medicaid, the effort reduced the rate of low birth weight infants by just 1 percent. In Tennessee, after a similar effort, researchers found "no concomitant improvements in use of early prenatal care, birth weight or neonatal mortality."
So why does our infant mortality rate exceed that of, say, Canada, where health care is free at the point of service? One reason is that we have a lot more tiny newborns. But underweight babies don't fare worse here than in Canada—quite the contrary.
The NBER paper points out that among the smallest infants, survival rates are better on this side of the border. What that suggests is that if we lived under the Canadian health care system, we would not have a lower rate of infant mortality. We would have a higher one.
A lot of things could be done to keep babies from dying in this country. But the health care "reform" being pushed in Washington is not one of them.
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People also need to look VERY carefully at how this infant mortality statistic is computed in different countries.
Scientific Method, stats, and the lies they propagate...
http://exposingtheleft.blogspot.com/2007/08/scientific-method.html
Some years back there was a study of pregnancy outcomes among female soldiers. All had identical prenatal care. The black soldiers still had worse pregnancy outcomes. It's just a fact of life and no one is to blame, except perhaps Mama Nature.
Sorry Reverend Al.
As usual, where liberals error when it come to science, or even “statistical studies”, they miss the fact that correlation is not causation.
Here's another reason:
"The reliability of the neonatal mortality estimates depends on accuracy and completeness of reporting and recording of births and deaths. Underreporting and misclassification are common, especially for deaths occurring early on in life."
"Misclassification", btw, includes live births which are reported as stillborn b/c the baby dies...after receiving no medical intervention.
http://www.who.int/healthinfo/statistics/indneonatalmortality/en/
The main problem is inconsistent measurement across nations. The United Nations Statistics Division, which collects data on infant mortality, stipulates that an infant, once it is removed from its mother and then "breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles... is considered live-born regardless of gestational age."16 While the U.S. follows that definition, many other nations do not. Demographer Nicholas Eberstadt notes that in Switzerland "an infant must be at least 30 centimeters long at birth to be counted as living."17 This excludes many of the most vulnerable infants from Switzerland's infant mortality measure. Switzerland is far from the only nation to have peculiarities in its measure. Italy has at least three different definitions for infant deaths in different regions of the nation.18 The United Nations Statistics Division notes many other differences.19 Japan counts only births to Japanese nationals living in Japan, not abroad. Finland, France and Norway, by contrast, do count births to nationals living outside of the country. Belgium includes births to its armed forces living outside Belgium but not births to foreign armed forces living in Belgium. Finally, Canada counts births to Canadians living in the U.S., but not Americans living in Canada. In short, many nations count births that are in no way an indication of the efficacy of their own health care systems.
The United Nations Statistics Division explains another factor hampering consistent measurement across nations:
"...some infant deaths are tabulated by date of registration and not by date of occurrence... Whenever the lag between the date of occurrence and date of registration is prolonged and therefore, a large proportion of the infant-death registrations are delayed, infant-death statistics for any given year may be seriously affected."
Source: National Center for Policy Research
I.E. in some nations, infant deaths are simply never reported because a 'live birth' was never reported. In other sources I have read, Japan which has the 'lowest infant mortality rate' also has one of the highest late term mortality rates. Some speculate that for cultural reasons, live births are being counted as stillborns if the child does not survive the first few hours.
Thanks for the link.
Thanks for the URL.
Thanks for the link.
What’s the Mexico rate?
Isn’t it illegal aliens skewing the stats?
One of my initial thoughts was that maybe the U.S. has more IVF births (wealthy nation that it is), which lead to more premature babies (even singleton IVF births tend to be more premature than non-IVF singleton births, and of course more IVF = more multiple births which = more complications/death).
1) Teen births
2) Drug use
3) Fatal flawed comparisons.
Agreed.
Dirty little secret is that "infant mortality" is based on two definitions. The easy one mortality is in other words dead.
The hard one, at least for some, is infant. To my knowledge a tragic stillbirth is considered an infant mortality in the U.S., but not so in other nations. Other nations (to my knowledge) also include a period of time breathing on their own after birth prior to including in infant mortality statistics.
Doesn't appear that any "reporting" or "journalists" have the time to reconcile the basic issue as to what constitutes an "infant" in order to provide decent information for comparison. But why should they, the academics and from an obvious lack of outrage from medical professionals, they don't either.
If we are going to count more than others as a reason to assail or hope and change for a different system- lets get the real number. Include the number of little girls and little boys that get whacked for convenience in-utero.
Let's get started defining "infant." That is the issue.
This is from the same crew that calls 20 and 21 teenagers.
Particularly when it is convenient for them to claim "children" without heathcare, or "children" killed by gun violence...
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