US infant mortality rate now worse than 28 other countries
By Patrick O’Connor
18 October 2008

A report issued Wednesday by the Centers for Disease Control and
Prevention (CDC) documents how the infant mortality rate in the United
States is growing in relation to other countries. The study, “Recent
Trends in Infant Mortality in the United States,” found that at least
28 other countries now have lower death rates for infants in the first
year of life.

The US’s relative position has declined steadily. In 1960, it had the
12th lowest infant mortality rate, but by 1990 had dropped to 23rd
place, and by 2004—the latest year of the CDC’s comparative world
figures on living standards—the US ranked 29th. The most recent study,
published in July and titled “The Measure of America,” estimated that
the US is now in 34th place.

The CDC report found that there was no improvement in the incidence of
US infant deaths between 2000 and 2005, a “plateau in the US infant
mortality rate represent[ing] the first period of sustained lack of
decline in the US infant mortality rate since the 1950s.” This “has
generated concern among researchers and policy makers,” the report
noted.

For the year 2000, the infant mortality rate was 6.89 per 1,000, a
rate that remained stagnant for five years before declining slightly
to 6.71 between 2005 and 2006.

The CDC noted: “The impact of child mortality is considerable: there
are more than 28,000 deaths to children under 1 year of age each year
in the United States.”

Several countries in Scandinavia (Sweden, Norway, Finland) and East
Asia (Japan, Hong Kong, Singapore) have an infant mortality rate below
3.5, almost half the US rate. The CDC’s 2004 rankings placed the US in
a tie with Poland and Slovakia, and only marginally ahead of Puerto
Rico and Chile. The US was behind every developed country in North
America, Western Europe, and Australasia, as well as Cuba, Hungary,
Israel, and the Czech Republic.

Infant mortality is a critical indicator of social progress. As the
CDC report explains, “Infant mortality is one of the most important
indicators of the health of a nation, as it is associated with a
variety of factors such as maternal health, quality and access to
medical care, socioeconomic conditions, and public health practices.”

This decline in world rankings is another expression of US
capitalism’s decay. The gutting of social programs by successive
Democrat and Republican administrations over the last four decades has
led to an extraordinary social reversion. A tiny layer at the top has
enriched itself through the dismantling of all impediments to the
accumulation of private wealth and corporate profit, supported by tax
cuts and the slashing of investment in critical social infrastructure.
That infant mortality rates are now stagnating for the first time in
five decades underscores the accelerating character of the social
crisis.

The CDC report documented the disparity of infant mortality rates
among racial classifications. “Non-Hispanic white,” Latino, and Asian-
American children had lower than average rates, while “American Indian
or Alaskan Native,” Puerto Rican, and “non-Hispanic black” families
had higher rates.

The report noted, however, that the “infant mortality rate did not
change significantly for any race/ethnicity group from 2000 to 2005.”

In 2005, African-American infants suffered a death rate of 13.63 per
1,000 births, by far the highest average. The CDC’s 2004 world
rankings indicate that a black American baby would have a better
chance of survival if born in Russia (which has a rate of 11.5) or
Bulgaria (11.7).

The CDC report did not assess infant mortality in relation to social
class or family income.

Another study released earlier this month, however, documented this
correlation. Published by the Robert Wood Johnson Foundation and
titled “America’s Health Starts With Healthy Children: How do States
Compare?” the report found: “In almost every state, shortfalls in
health are greatest among children in the poorest or least-educated
households, but even middle-class children are less healthy than
children with greater advantages. Within each racial or ethnic group,
a steep income gradient is evident. Children’s general health status
improves as family income increases.”

It also reported: “Nationally, and in every state, infant mortality
rates increased with decreasing levels of mothers’ education.” The
mortality rate for children whose mothers had completed 16 or more
years of school was 4.2 deaths per 1,000 births, compared to 7.8
deaths for children whose mothers had completed 11 years or less of
school.

The failure to improve the infant death rate between 2000 and 2005
came despite significant advances in medical technology, including
care for prematurely born babies.

What the CDC termed “preterm birth”—i.e., those at less than 37 weeks
gestation—is a key risk factor for infant mortality. In 2005, 69
percent of all infant deaths occurred to preterm babies. The report
stated: “The plateau in the US infant mortality rate from 2000 to 2005
was largely due to the combination of the increase in the percentage
of very preterm births and the lack of decline in the infant mortality
rate for these births.”

Only those parents who can afford to pay for treatment can be sure
that their premature babies will receive the necessary care.
Similarly, many families are finding it increasingly difficult to
afford the advanced medical treatment which many infants require in
their first year. About 45 million Americans, or 15 percent of the
population, are now estimated to be without any form of health
insurance.

At every level, corporate control over the health care system distorts
and undermines the rational provision of medical services. Per capita
US health spending was $6,714 in 2006, more than twice the average of
other advanced countries. But this spending has failed to improve the
population’s health. Infant mortality is one indication of this;
another is the extraordinary fact that 41 countries now have a longer
life expectancy than does the US.

Official per capita health spending figures are in fact misleading. If
the resources invested in genuine medical care and treatment were to
be calculated and compared, there is little doubt that the US would
rank far below many other countries. A substantial portion of
purported American health spending is simply siphoned off as profit by
the major health firms, insurance companies, and pharmaceutical
interests.


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