Newborn deaths in US at the bottom of the list

[DocDiggs]

U.S. gets poor grades for newborns' survival

Nation ranks near bottom among modern nations, better only than Latvia


CHICAGO - America may be the world’s superpower, but its survival rate for newborn babies ranks near the bottom among modern nations, better only than Latvia.

Among 33 industrialized nations, the United States is tied with Hungary, Malta, Poland and Slovakia with a death rate of nearly 5 per 1,000 babies, according to a new report. Latvia’s rate is 6 per 1,000.

“We are the wealthiest country in the world, but there are still pockets of our population who are not getting the health care they need,” said Mary Beth Powers, a reproductive health adviser for the U.S.-based Save the Children, which compiled the rankings based on health data from countries and agencies worldwide.

The U.S. ranking is driven partly by racial and income health care disparities. Among U.S. blacks, there are 9 deaths per 1,000 live births, closer to rates in developing nations than to those in the industrialized world.

“Every time I see these kinds of statistics, I’m always amazed to see where the United States is because we are a country that prides itself on having such advanced medical care and developing new technology ... and new approaches to treating illness. But at the same time not everybody has access to those new technologies,” said Dr. Mark Schuster, a Rand Co. researcher and pediatrician with the University of California, Los Angeles.

Less healthy than Britain
The Save the Children report, released Monday, comes just a week after publication of another report humbling to the American health care system. That study showed that white, middle-aged Americans are far less healthy than their peers in England, despite U.S. health care spending that is double that in England.


In the analysis of global infant mortality, Japan had the lowest newborn death rate, 1.8 per 1,000 and four countries tied for second place with 2 per 1,000 — the Czech Republic, Finland, Iceland and Norway.

Still, it’s the impoverished nations that feel the full brunt of infant mortality, since they account for 99 percent of the 4 million annual deaths of babies in their first month. Only about 16,000 of those are in the United States, according to Save the Children.

The highest rates globally were in Africa and South Asia. With a newborn death rate of 65 out of 1,000 live births, Liberia ranked the worst.

In the United States, researchers noted that the population is more racially and economically diverse than many other industrialized countries, making it more challenging to provide culturally appropriate health care.

About half a million U.S. babies are born prematurely each year, data show. African-American babies are twice as likely as white infants to be premature, to have a low birth weight, and to die at birth, according to Save the Children.

Low birth weight
The researchers also said lack of national health insurance and short maternity leaves likely contribute to the poor U.S. rankings. Those factors can lead to poor health care before and during pregnancy, increasing risks for premature births and low birth weight, which are the leading causes of newborn death in industrialized countries. Infections are the main culprit in developing nations, the report said.

Other possible factors in the U.S. include teen pregnancies and obesity rates, which both disproportionately affect African-American women and also increase risk for premature births and low birth weights.

In past reports by Save the Children — released ahead of Mother’s Day — U.S. mothers’ well-being has consistently ranked far ahead of those in developing countries but poorly among industrialized nations. This year the United States tied for last place with the United Kingdom on indicators including mortality risks and contraception use.

While the gaps for infants and mothers contrast sharply with the nation’s image as a world leader, Emory University health policy expert Kenneth Thorpe said the numbers are not surprising.

“Our health care system focuses on providing high-tech services for complicated cases. We do this very well,” Thorpe said. “What we do not do is provide basic primary and preventive health care services. We do not pay for these services, and do not have a delivery system that is designed to provide either primary prevention, or adequately treat patients with chronic diseases.”

http://msnbc.msn.com/id/12699453/

[Bluehawk]

Doc... as a medical man, please explain to me/us why it is that a newborn death rate of 5 or 9 per 1,000 is noteworthy.

That rate doesn't seem too surprising or disturbing to me, for some reason.

What would an "acceptable" newborn death rate be... other than zero, which is (I take it) impossible?

I am serious about this... trying to reason out why it might be imagined that birth is or ought to be without risk, or what level of risk or mortality would possibly be acceptable.

If the above report is just another attempt to bolster more claims that African-American people statistically have it worse off than anyone else in the world, then screw it.

If, on the other hand, there is some other more significant national issue involved worthy of note, then what the heck IS it that we don't already know about (e.g. how intensely nutty health care insurance is) ?

[Woodmonkey]

Much of that low birth weight, I suspect, is due to drug use. Strange that they don't mention it, but maybe not - I don't think that infants are routinely screened for residual drugs.

When I had my son in 1969 (in the Netherlands), my OB told us that they had just beaten out Sweden for having the lowest infant mortality rate in the world. He then, rather slyly ( ) told me that the US was something like 12 in the world.

[DocDiggs]

Originally Posted by Bluehawk

Doc... as a medical man, please explain to me/us why it is that a newborn death rate of 5 or 9 per 1,000 is noteworthy.

That rate doesn't seem too surprising or disturbing to me, for some reason.

What would an "acceptable" newborn death rate be... other than zero, which is (I take it) impossible?

I am serious about this... trying to reason out why it might be imagined that birth is or ought to be without risk, or what level of risk or mortality would possibly be acceptable.

If the above report is just another attempt to bolster more claims that African-American people statistically have it worse off than anyone else in the world, then screw it.

If, on the other hand, there is some other more significant national issue involved worthy of note, then what the heck IS it that we don't already know about (e.g. how intensely nutty health care insurance is) ?

Already I'm beginning to think putting this in was a mistake.

I was unable to get the graphs for this article to copy/paste along with the article. I will try again.

I want to stress right now that this article refs this as an INTERNATIONAL problem, not just a US one. It cannot be dumped off on drug use or any of the buzz-ideas that are common...it is far too complex for such simplistic "causes".

While any number per 1000 here may seem to be insignificant, this is the manner in which medical problems and mortality rates, etc., are expressed. If 9/1000 doesn't seem like much, multiply that per figure by 100 for what may seem a more significant figure. Part of the point that is discussed in the article is that the US figure is at the bottom of the industrialized nations. The article made the point also that the primary problem here is the orientation of the US health system which is geared to high-tech (and intensely expensive) diagnosis and treatment as opposed to the much more generalized and cheaper family/individual/primary care orientation in most of the other industrialized nations. ...and of course, in third world nations, there may be little if any health care available except to the proportionately wealthy and those of the power structure. There is also a direct correlation between manner and availability of health care and adequate diet of reasonable quality.

I am back after going to the article and attempting to copy/paste the graph. Didn't work. Perhaps someone in TP can do it. In the meantime, the source at the end of the article takes the reader to the article WITH graph.

[Woodmonkey]

Originally Posted by DocDiggs

I was unable to get the graphs for this article to copy/paste along with the article. I will try again.

I wish I could help you, Doc, but my regular puter is being fixed and this Mac I'm using just doesn't do all that stuff.

I want to stress right now that this article refs this as an INTERNATIONAL problem, not just a US one. It cannot be dumped off on drug use or any of the buzz-ideas that are common...it is far too complex for such simplistic "causes".

Drug use is not simplistic and it is, unfortunately, not routinely tested for in the US. It should be because the infants start off life with a deck stacked against them.

The countries would have to be separated out by categories, I would think. Countries like in Africa have conditions that the Western countries don't have to face.

While any number per 1000 here may seem to be insignificant, this is the manner in which medical problems and mortality rates, etc., are expressed. If 9/1000 doesn't seem like much, multiply that per figure by 100 for what may seem a more significant figure.

It adds up and quickly.

[DocDiggs]

Originally Posted by Woodmonkey

I wish I could help you, Doc, but my regular puter is being fixed and this Mac I'm using just doesn't do all that stuff.



Drug use is not simplistic and it is, unfortunately, not routinely tested for in the US. It should be because the infants start off life with a deck stacked against them. [Yes, but this is not about just the US...we a very tiny portion of the 6+ billions of the Earth's peoples. It's time to think globally AS WELL AS about how we deal with health care questions here.]

The countries would have to be separated out by categories, I would think. Countries like in Africa have conditions that the Western countries don't have to face. [Ref the source document where the graph is available. Perhaps that will help clarify the issue for you. The impact of the article is greater and more understandable with the graph as it does illustrate who is doing a good job and who is not. It does not show the US, but that is discussed in the article.]



It adds up and quickly.