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Can a Higher Infant Mortality Rate Be A Good Thing?

August 22, 2008

You wouldn’t think so. The death of a newborn child is a tragedy, and the fact that the United States has a higher infant mortality rate than other developed countries is often cited as a serious failing of America’s health care system. But according to Dr. Linda Halderman, the higher U.S. rate is due at least in part to the fact that we try to save the lives of more infants than do other countries:

Low birth weight infants are not counted against the “live birth” statistics for many countries reporting low infant mortality rates.

According to the way statistics are calculated in Canada, Germany, and Austria, a premature baby weighing <500g is not considered a living child.

But in the U.S., such very low birth weight babies are considered live births. The mortality rate of such babies — considered “unsalvageable” outside of the U.S. and therefore never alive — is extraordinarily high; up to 869 per 1,000 in the first month of life alone. This skews U.S. infant mortality statistics.

Norway boasts one of the lowest infant mortality rates in the world. But when the main determinant of mortality — weight at birth — is factored in, Norway has no better survival rates than the United States.

More. The article also notes other differences in the way infant mortality is calculated by different countries that skew their infant mortality rate. Many countries, for example, won’t count a child as a live birth if he dies within 24 hours of being born. Since 40% of all infant mortality occurs within the first 24 hours after birth, this fact makes the infant mortality rate of those countries appear a lot better than it actually is.

(HT: Coyote Blog)

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12 Comments
  1. August 22, 2008 9:44 am

    Very interesting, though this sadly means more babies are dying than we think.

    I’ve heard it said that the US infant mortality rate is also higher because we have a higher number of multiple-baby pregnancies, which are higher risk. Supposedly one reason there are more premature births here is our high number of women who undergo fertility treatments and IVF.

    International comparisons are often unreliable because of different standards for statistical gathering. When journalists worry how India is cranking out tens of thousands of engineers, they neglect to notice that in India “engineer” includes mechanic and repairman as well as the American B.S. degree.

    So too with military statistics. When people fret about the size of China’s or N. Korea’s army, they don’t examine whether the military does double-duty as the local police force.

  2. David Nickol permalink
    August 22, 2008 9:56 am

    This doesn’t explain why the infant-mortality rate among blacks in the United States is twice that of whites. I don’t think a higher rate of infant mortality within specific groups in the United States can be a good thing.

  3. Zak permalink
    August 22, 2008 10:09 am

    That’s fascinating. Infant mortality was one of those measures I assumed was standardized world wide.

  4. August 22, 2008 10:14 am

    Next up from BA: “Do child labor laws harm children?”

  5. blackadderiv permalink
    August 22, 2008 10:16 am

    Matt,

    Nah. I’ve already done that one.

  6. August 22, 2008 10:21 am

    David,

    Clearly not, but I wonder if those figures are normalized for factors such as maternal substance abuse and obesity.

    In other words, is it a reflection of failing to provide the same health care to members of different ethnic groups, or is it a result of a cultural tendency towards bad health (probably correlating strongly to poverty) in a specific ethnic group.

  7. radicalcatholicmom permalink
    August 22, 2008 10:34 am

    Very very interesting post, BA.

  8. August 22, 2008 1:01 pm

    International comparisons are often unreliable because of different standards for statistical gathering. When journalists worry how India is cranking out tens of thousands of engineers, they neglect to notice that in India “engineer” includes mechanic and repairman as well as the American B.S. degree.

  9. August 22, 2008 1:44 pm

    In parts of the country where substance abuse and teenage pregnancy is rampant, infant mortality is at levels seen only in underdeveloped countries. It’s certainly not due to lack of medical care.

  10. none permalink
    August 22, 2008 2:09 pm

    Or racism.

  11. LactLady permalink
    August 22, 2008 8:58 pm

    Dr Halderman also reports that “Since 2000, 42 of the world’s 52 surviving babies weighing less than 400g (0.9 lbs.) were born in the United States.” That is 80% of these smallest ones.

  12. joseph permalink
    August 25, 2008 10:17 am

    According to the way statistics are calculated in Canada, Germany, and Austria, a premature baby weighing <500g is not considered a living child.

    Which country is Obama from?

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