CDC ranks US 29th worldwide for infant mortality rates
October 23, 2008 10:12:01
by Anna
Web Correspondent
Planned Parenthood Minnesota, North Dakota, South Dakota Action Fund
When the CDC released its 2006 infant mortality report last Wednesday, October 15, a barrage of questions immediately followed. How is it that the United States, one of the most industrialized countries in the world, has only the 29th lowest infant mortality rate, with more deaths before one year of age than a whole slew of European and East Asian countries? How is it that this is the case even though our government spends twice as much on health care as those of other industrialized nations?
The 2006 figure for infant deaths came out to about 6.71 deaths per 1,000 lives births. As a point of comparison, the 2005 figure was 6.86-indicating slight improvement, but certainly not enough to boost the U.S. into a position alongside the 22 countries with rates of less than 3.5. The lowest rate was found in Singapore at 2.0, with nations like Hong Kong and Japan finishing just behind with rates of 2.5 and 2.8 respectively.
Back in 1960s, the U.S. had the 12th lowest infant mortality rate in the world with a rate of 26 deaths per 1,000 births. While we have certainly lowered our numbers since then, our plummeting worldwide rank indicates that other nations have done so far more quickly and effectively. Another disturbing aspect of our current infant mortality rate is the differential between rates for different groups. The 2005 rate for black Americans was 13.63 infant deaths per 1,000 births, while the rate for whites was 5.76, bringing to light major social issues like equality of health care.
One possible explanation for our infant mortality rate that pops up again and again is the problem of preterm or premature births. More than two-thirds of infant deaths are connected to this issue, and significantly, from 2000 to 2005 the U.S. premature birth rate increased from 11.6 to 12.7 percent of all births.
A preterm birth occurs when less than 37 weeks of gestation have been completed and can lead to a variety of infant health problems. These include respiratory distress syndrome, which causes breathing difficulties, apnea, in which an infant stops breathing for 20 seconds or more at a time, internal bleeding in the brain, heart conditions like patent ductus arteriosis, increased likelihood of infections, chronic lung disease, and anemia, among others. All of these conditions can mean higher risk for infant mortality.
And of course, when we are talking about pregnancies and premature births, we have to discuss what causes these early deliveries in the first place. The number of late preterm births, defined as births between 34 and 36 weeks of gestation, has seen the most dramatic increase in recent years. About 92 percent of these deliveries are by Caesarian section, raising new questions about the impact of this practice on infant health.
Other factors such as health problems during pregnancy play a very substantial role in encouraging preterm births: Late or no prenatal care, smoking, alcohol or drug use, domestic violence, extreme stress, and "long working hours with long periods of standing" can all lead to early delivery. The same goes for preexisting maternal health problems like high blood pressure, being underweight or obese, and clotting disorders. Another cause can be short turnaround between pregnancies, common in women with limited access to contraceptives like birth control pills.
Nobody claims to have completed the puzzle of why the United States suffers from relatively high infant mortality, but some of the pieces are becoming obvious-preterm birth, for one, as well as overarching social problems like poverty and inadequate health care. What does it come down to? Making sure that all mothers are healthy, ready to have children, and able to provide for those children. Not an easy task by anyone's standards, but who knows? Maybe the next step is getting over our pride and taking some pointers from the 2.0's and 2.5's of the world
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