U.S. Newborn Death Rate Trails Behind 40 Other Nations

[Electric Monk]

Source: IBTimes

New research done by the World Health Organization (WHO) shows that babies under four weeks old account for 41 percent of child deaths worldwide.


Newborn babies rest in cots. The birth rate for U.S. teenage girls declined for a second year in 2009. A recent study showed that annual newborn deaths in the U.S. decreased from 4.6 million to 3.3 million from 1990 to 2009. However, the study's authors say progress is too slow.

A report published on Tuesday by WHO said babies born in the U.S. have a higher risk of dying within the first month of life than babies born in 40 other countries.

In the U.S., the newborn death rate is 4.3 per 1,000 live births, although, in 1990 the United States had the 28th lowest risk.

(snip)

Some countries that outranked the U.S. in terms of newborn death rates were South Korea, Cuba, Poland, Andorra and Israel.

Read more: http://www.ibtimes.com/articles/206534/20110831/infant-mortality-newborn.htm

[HysteryDiagnosis]

1. At least they didn't forget Poland this time..... I wonder why the richest and most

"advanced" nation in the world rates like this? It doesn't make sense, not really.

[liberation]

3. It's grammar's fault. The term "rich nation" implies that everyone in that nation is rich

When it really is a "nation where a few are rich," especially given we have one of the worst, if not the worst, social wealth divides among industrialized nations.

[AikidoSoul]

22. The U.S. has had high infant deaths + high rates of infant chronic illnesses for a long time.

See this 2000 report from a prestigious National Academy of Science Committee that issued this press release on the subject (the link doesn't work anymore, but you can search the press release on the NAS website):


http://www4.nationalacademies.org/news.nsf/isbn/0309070864?OpenDocument

Read Full Report
Date: June 1, 2000
Contacts: Bill Kearney, Media Relations Associate
Megan O'Neill, Media Relations Assistant
[phone]; e-mail <[e-mail]>

FOR IMMEDIATE RELEASE

Major Advances in Biology Should Be Used to Assess
Birth Defects From Toxic Chemicals

WASHINGTON -- New discoveries in developmental biology and genetics should be used when scientists analyze chemicals for their potential to cause birth defects, says a new report from the National Research Council of the National Academies. Given recent advances in understanding how the process of normal development occurs, methods can now be devised to determine how chemicals disrupt it in humans.

Approximately half of all pregnancies in the United States result in prenatal or postnatal death or an otherwise less than healthy baby. And major developmental defects, such as neural tube and heart deformities, occur in approximately 120,000 of the 4 million infants born here each year. Exposure to toxic chemicals, both manufactured and natural, cause about 3 percent of all developmental defects, and at least 25 percent might be the result of a combination of genetic and environmental factors.

"Many manufactured chemicals, as well as chemicals that occur in nature, have not been adequately evaluated for developmental toxicity," said Elaine Faustman, chair of the committee that wrote the report and professor of environmental health and director of the Institute for Risk Analysis and Risk Communication, University of Washington, Seattle. "Our report provides a blueprint for using new findings about the dynamic processes involved in normal development to further our understanding of how human development may be affected by potentially toxic chemicals. Collaboration among scientists from many disciplines will be key in this endeavor, as will the integration of information from various databases."

New approaches to developmental toxicology are needed that emphasize simultaneous research on several fronts by experts from multiple scientific disciplines, the report says. It urges scientists to take advantage of new knowledge about the human genome when studying how genes and the environment interact to cause developmental defects. The report also calls for an intensified effort to expand the understanding of how even the smallest, simplest laboratory animals can serve as toxicological models for human biological systems, given recent advances in this area.

In most animals -- including those commonly used in laboratories, such as the fruit fly, roundworm, zebrafish, and mouse -- scientists recently have discovered how specific cells communicate with each other, ultimately activating proteins that turn particular genes on and off, thus regulating development. These "signaling pathways" are used repeatedly in various combinations at different times and locations in the embryo and fetus. Chemical disruption of these pathways could lead to abnormal development. Strikingly similar pathways are found in a wide range of animal species, including humans, and have changed very little over the course of time, which means that studying the effects of chemicals on signaling pathways in animal models could help facilitate understanding of abnormal development in humans, the report says.

Relatively simple assessments using animal models, such as the roundworm and fruit fly, could be used more effectively to provide clues about which developmental pathways are most affected by specific chemicals, the committee said. Based on findings from these tests or general concern about a chemical's prevalence in the environment, more extensive studies could be conducted on animals whose biological systems more closely resemble those of humans.

In addition, major new advances in genetics will help researchers gain insight into how chemicals affect human development, the report says. Mapping the human genome will increase understanding of gene function and expression, and help researchers identify unique alterations in genes, known as polymorphisms. Recent research has shown that individuals with certain polymorphisms, who are also exposed to certain chemicals in utero, have a higher occurrence of specific developmental defects than the general population. New information on genetic variability in humans, especially polymorphisms, is seen as key to understanding how the relationship between genes and the environment leads to developmental defects.

The committee emphasized that all stages of human development -- from conception to puberty -- should be examined in toxicity studies, since all developmental periods are potentially susceptible to toxic agents. In addition, there is a need to look at all adverse developmental outcomes, including growth retardation, behavioral effects, and death.

The vast amounts of data that could be generated by testing thousands of chemicals for potential developmental toxicity will require new databases capable of organizing this information in a way that is useful for risk assessment, the committee said. The databases should include information from industry, academia, and government researchers, and be linked with existing databases of developmental biology and genomics, as well as those describing how drugs and chemicals are metabolized by the body. A separate relational database should be set up for chemicals that are found to interact with particular signaling pathways. This would help researchers study whether different chemicals that affect the same pathway are acting in a similar manner.

The lack of opportunities for collaboration among scientists from different fields has impeded the application of new information to improve developmental toxicology and risk assessment, the committee said. To overcome this, educational programs and professional workshops should be organized to facilitate interaction among researchers in developmental toxicology, developmental biology, genomics, medical genetics, epidemiology, and biostatistics.

The study was sponsored by the American Industrial Health Council, Centers for Disease Control and Prevention, U.S. Department of Defense, U.S. Environmental Protection Agency, U.S. Department of Veterans Affairs, National Center for Toxicological Research, National Institute of Environmental Health Sciences, National Institute of Child Health and Human Development, and National Institute for Occupational Safety and Health. The National Research Council is the principal operating arm of the National Academy of Sciences and the National Academy of Engineering. It is a private, nonprofit organization that provides advice on science and technology under a congressional charter. A committee roster follows.

Read the full text of Scientific Frontiers in Developmental Toxicology and Risk Assessment for free on the Web, as well as more than 1,800 other publications from the National Academies. Printed copies are available for purchase from the National Academy Press Web site or at the mailing address in the letterhead; tel. [phone] or 1-800-624-6242. Reporters may obtain a pre-publication copy from the Office of News and Public Information at the letterhead address (contacts listed above).


NATIONAL RESEARCH COUNCIL
Commission on Life Sciences
Board on Environmental Studies and Toxicology
Toxicology and Risk Assessment Program

Committee on Developmental Toxicology

Elaine M. Faustman, Ph.D. (chair)
Professor, Department of Environmental Health, and
Director, Institute for Risk Analysis and Risk Communication
University of Washington
Seattle

John C. Gerhart, Ph.D. (vice chair)*
Professor, Department of Molecular and Cell Biology
University of California
Berkeley

Nigel A. Brown, Ph.D.
Professor of Developmental Biology
Department of Anatomy and Developmental Biology
St. George's Hospital Medical School
London

George P. Daston, Ph.D.
Toxicologist
Miami Valley Laboratories
Procter & Gamble Co.
Cincinnati

Mark C. Fishman, M.D.
Chief of Cardiology; Director, Cardiovascular Research Center, and
Chief, Developmental Biology Laboratory
Massachusetts General Hospital, and
Professor of Medicine
Harvard Medical School
Boston

Joseph F. Holson, Ph.D.
President and Director
WIL Research Laboratories Inc.
Ashland, Ohio

Herman B.W.M. Koëter, Ph.D.
Principal Administrator
Environmental Health and Safety Division
Organization for Economic Cooperation and Development
Paris

Anthony P. Mahowald, Ph.D. *
Louis Block Professor and Chair
Department of Molecular Genetics and Cell Biology
University of Chicago
Chicago

Jeanne M. Manson, Ph.D.
Fellow, Center for Clinical Epidemiology and Biostatistics
University of Pennsylvania
Philadelphia

Richard K. Miller, Ph.D.
Professor and Associate Chair of Obstetrics and Gynecology, and
Professor of Environmental Medicine
University of Rochester School of Medicine and Dentistry
Rochester, N.Y.

Philip E. Mirkes, Ph.D.
Research Professor, Department of Pediatrics
University of Washington
Seattle

Daniel W. Nebert, M.D.
Professor, Department of Environmental Health
University of Cincinnati Medical
Center, and
Professor, Department of Pediatrics
Division of Human Genetics
Children's Hospital Medical Center
Cincinnati

Drew M. Noden, Ph.D.
Professor of Embryology
Department of Biomedical Sciences
College of Veterinary Medicine
Cornell University
Ithaca, N.Y.

Virginia E. Papaioannou, Ph.D.
Professor of Genetics and Development
College of Physicians and Surgeons
Columbia University
New York City

Gary C. Schoenwolf, Ph.D.
Professor of Neurobiology and Anatomy, and
Member, Huntsman Cancer Institute
School of Medicine
University of Utah
Salt Lake City

Frank Welsch, D.V.M.
Senior Scientist and Head, Teratology Laboratory

Chemical Industry Institute of Toxicology
Research Triangle Park, N.C.

William B. Wood, Ph.D. *
Professor, Department of Molecular, Cellular, and Developmental Biology
University of Colorado, Boulder, and
Member, Cancer Institute
University of Colorado Health Sciences Center
Denver

RESEARCH COUNCIL STAFF

Carol A. Maczka, Ph.D.
Director, Toxicology and Risk
Assessment Program

Abigail E. Stack, Ph.D.
Project Director

* Member, National Academy of Sciences

[indepat]

38. It does when most of the wealth of the richest nation in the world is highly concentrated

among a relative few and the lack of adequate pre-natal care for the countless uninsured/under-insured. These are but a few of the joys of living in a country in which almost all acts of government are for exclusive benefit of large corporation and the uber-wealthy. :shrug: :patriot:

[dipsydoodle]

2. Full list here

Not only did Cuba beat the USA check out Cuba's reducing figures across the years.

http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate

[No Elephants]

4. Will the media give this the same time it gave scores of Republicans to say the U.S. has the best

health care in the world? Every day or two for months?

[AikidoSoul]

5. U.S. Infant Mortality Rate Worse Than in 40 Other Countries

Source: International Business Times

Babies born in the United States have a higher chance of dying in their first month than babies in much of the developed world, according to a new report on infant mortality rates.

Researchers at the World Health Organization looked at mortality rates for newborn babies over the last 20 years. Overall the rates of newborn deaths diminished, from 4.6 million in 1990 to 3.3 million in 2009, or from 33.2 deaths per 1,000 live births to 23.9 deaths per 1,000 births.

America made strides in the last two decades, but because it curtailed infant mortality rates by 26 percent, or less than the average drop, the United States now lags behind 40 other countries including Lithuania, Israel and Cuba. American newborns die at about the same rate as in Qatar, Croatia and the United Arab Emirates.

In some cases, deaths could be prevented by simple sanitary measures or by providing antibiotics. That is particularly true in countries towards the bottom of the list -- Afghan babies die at the rate of one per 19 in the first month of life, the worst recorded rate, and India, Nigeria, Pakistan, China and Democratic Republic of Congo produce more than half of the world's newborn deaths.

Read more: http://img.ibtimes.com/www/articles/20110831/206614_u-s-infant-mortality-infant-mortality-u-s-infant-mortality-america-infant-mortality-rates.htm

---

Nothing makes me more upset than this. This is how it goes when the top 1/10 of 1 percent gather unto themselves everything that they possibly can at the expense of almost everyone else -- especially the most vulnerable. Our health suffers, but especially our fragile infant population.

[Permanut]

6. And the policies that result in this ranking...

are fully approved by the "pro-life" wackos. The cognitive dissonance is staggering.

[KamaAina]

9. "Life begins at conception and ends at birth."

:eyes:

[AikidoSoul]

26. Wow! Good one. I may borrow this on a regular basis when

dealing with so called "pro-life" Republicans.

I still don't think they really understand what "pro-life" really means.

[leveymg]

7. That's one approach to the SS and schools "crises."

Finally, policy solutions that work.

[AikidoSoul]

10. Kill them while they're young? Is this the prevailing policy of the elite rich and powerful?

Reduce the population of the poor and the outputs required to sustain them?

:evilfrown:

[Alameda]

16. sure looks like that, doesn't it?

[moc]

27. Actually (this will turn your stomach)

I have a colleague who is heavily involved in lobbying at the state and federal level for programs that are trying to reduce infant mortality in communities around the country.

He told me he was meeting with a U.S. legislator (he still won't tell me who) and describing the high medical costs associated with preterm birth (the leading cause of infant death in the U.S.). This legislator looked thoughtful and said "So, it would be cheaper if they died, right?"

I kid you not.

[AikidoSoul]

28. I have no problem whatsoever believing what you say.

It is a travesty beyond belief -- and yet the American public in general cannot bring themselves to face the truth of what is really going on.

:mad:

[moc]

29. I think I would have punched the guy, myself.

My colleague is clearly better suited for the lobbying gig than I am. He said he turned it around without missing a beat by asking the a-hole how he would feel if it were his grandchild there in the NICU.

[KamaAina]

13. Did you forget something?

Like this? :sarcasm:

[leveymg]

19. Do you really think that's necessary?

[KamaAina]

35. Around here, it never hurts.

'Cause you just never know.

[provis99]

8. did they account for race?

African-American babies have a much higher risk of infant mortality than other races; that may be skewing the results.

[KamaAina]

12. "Skewing the results" how?

Last time I checked, African American babies were as American as any other babies. If anything, that makes this even more appalling: to think that African American babies are more likely to die than those in Qatar or Croatia or wherever.

[provis99]

14. "Developed world", essentially means mostly white or Asian countries.

So yes, if they don't account for race, the results will be skewed.

[KamaAina]

17. You do consider African Americans (and Asian Amreicans) part of the developed world?

Right?

[AtheistCrusader]

20. I think you are misunderstanding the poster.

In the united states, 38,929,319 people are identified by the census as african american, or, 12.6% of the population.

The UK, people of african descent only make up 485,277 or, 0.8% of the population.


I don't know the nature of the differential in infant mortality (Perhaps sickle cell anemia? Some other issue? I don't know) between the races, but if the contention the author made about people of (recent) african descent, population numbers may explain the difference.

If you consider people of all 'black' descent in the UK, (caribbean, other) it is still only 2% of the population.


So the remaining questions to answer are:

1. How do we compare to other 'developed nations' with similar populations of people of african descent.
2. Why does that make a difference.

[moc]

24. Disparities in pregnancy outcomes are strongly related to income inequality.

The greater the difference between the rich and poor in a country, the larger the disparities we see between populuation subgroups. This has been shown between countries as well as between states and between municipalities in the U.S.

When income inequality decreased following social program implementation in the 60s/70s, the disparity between AA and white infant IMRs decreased too. When income inequalities began to widen, the disparity widened again.

I can probably dig up references if you are interested although it's not my area of research.

[AtheistCrusader]

40. That seems likely.

Having a child is rather expensive, and we don't have a lot of people with insurance in this country. So pre-natal care and whatnot likely suffers.

[Name removed]

18. Deleted message

Message removed by moderator. Click here to review the message board rules.

[moc]

23. You are incorrect. Higher substance use does not account for higher infant mortality.

The population-attributable risk for substance use for explaining disparities in pregnancy outcome is virtually nil. The same can be said for the other "myths" you sling (crime, teenage pg, nutrition, etc). I refer you to the following for more detail on this issue:

Strobino, D., O'Campo, P., Schoendorf, K. C., Lawrence, J. M., Oberdorf, M. A., Paige, D. M. (1995). A strategic framework for infant mortality reduction: Implications for "Healthy Start". Milbank Quarterly, 73, 507-533.

As I stated in my other post, a college educated AA woman is more likely to experience an infant loss than a white woman who didn't complete high school.

I'm happy to provide more information if you are interested, but given your low post count and inflammatory rhetoric, I suspect you are wedded to your preconceived notions of the sources of health disparities in our country.

[caseymoz]

25. Bullshit. You should check again.

For one thing, teen pregnancy has been dropping in all ethnicities for a decade. If the problem were primarily teenage pregnancies, you should see the decline of infant mortality accelerate. That hasn't happened. The number of infants who die from alcohol and drug related problems is not significant enough to account for our dropping rank.

For another thing, (bear with me, it sounds off topic) African-American health lags behind whites in any medical category you want to name, and have a higher mortality rate for all of them. Diabetes? Higher rate, worse treatment. Heart disease? Same thing. This all can't be alcohol, drug and violent crime related.

Third, African Americans are only fifteen percent of the population. Perhaps, hypothetically, their poorer health takes us from ranking like number 34 to number 40. It can't account for the US being at such a poor rank.

Fourth, why should they grade this on a racial curve? If race is a factor, whether it's behavioral or not, then it's a factor. Don't you think almost every country in the world has a disadvantaged minority who are regarded as behaving badly? If you don't, you're simply ignorant. Almost every country has it including most that rank well ahead of us.

Quit looking for excuses that it isn't an indication of a serious failures in our health system. And definitely, don't resort to blaming it on one race, in a racist manner, when a glance at the numbers show it's hogwash.

You want an indication of what the problem is, if not direct evidence? C-sections in the US are about 4-15 times higher rates than any other country on earth. That shows there's something seriously wrong with how obstetrics The US just isn't doing health right, in general.

[moc]

21. You are correct, but your interpretation of what it means is incorrect.

The infant mortality rate (IMR) for African American infants typically runs 2.5 times U.S. white infants. However, the distribution of demographic characteristics in the U.S. does not explain the differential in the IMR between the U.S. and other countries. Indeed, African origin individuals in other countries have better pregnancy outcomes. Similar issues are seen for Latinos. Latinos (specifically those of Mexican origin) have lower IMR than non-Latino whites in the U.S. However, there is evidence that the longer they are in the U.S. (e.g., with passing generations), their pg outcomes degrade. In other words, the American environment is "toxic" so to speak.

Even if you took out AA births/deaths, the IMR for the U.S. would still be around 6 per 1000 which is no where close to the lowest rates seen in other industrialzed countries that hover in the 2-3 per 1000 range.

I want to go back to my original point. AA infants are 2.5 times as likely to die before their first birthday. The IMR for AA infants is >13 per 1000, which rivals IMRs in developing countries. This disparity is not explained by economic disparities. The infant of an AA college educated woman is more likely to die before his/her first birthday than the infant of a white woman with less than a HS degree.

We should be ashamed as a country.

(doctorate in maternal and child health; professor at a school of public health)

[Maine_Nurse]

30. I agree with you on a national scale, but...

when you eliminate race by having a large geographical area that is over 99% white, then you see the differences by socioeconomic status. I live in such an area and did my maternal/newborn clinical at the one advanced hospital that covered the entire area (the whole northern half of Maine). It also happened to be the hospital that treated more opiate (and often benzo) addicted newborns per capita than anywhere else in the country. Once the racial variable is largely eliminated, there is a survival rate difference by "class". If nothing else, mere physical access to a hospital capable of dealing with high-risk pregnancies becomes an issue when you live 200 miles away from that hospital and there is no such thing as public transportation, not even Greyhound. These differences may be so small as to be insignificant in most of the country, but they are very real and important in areas where they exist.

[moc]

41. You are absolutely correct. I'm sorry; I didn't mean to imply that social class

wasn't important. Rather, I was making the point that the higher rate of poverty among African Americans does not explain why black infants are more likely to die. However, you are correct that social class in and of itself is an important predictor of infant mortality. Interestingly, the impact of individual social class is exacerbated in countries with high levels of income inequality. In countries in which there is a large gap between the rich and poor (like the U.S.), there is a higher disparity in the infant mortality rate for low vs. high SES individuals. In countries with strong social safety nets like universal health care, strong education, decent housing, etc, the disparity is smaller. In other words, the culture in this country which supports unconstrained capitalism and reveres obscenely wealthy CEOs while undermining the rights of workers results in more babies dying. How's that for a "culture of life"?

[Name removed]

11. Deleted message

Sub-thread removed by moderator. Click here to review the message board rules.

[SoapBox]

15. Chew on this report, anti-abortion types...

They loves the fetus...but beyond that point, they just give it the finger.

[AikidoSoul]

32. I would like to see your view promo'd in a bumper sticker

Because it's true. Totally. It is the absolute best example of MePublican hypocrisy -- and I would like to see it thrown into their faces in a way that is totally clear to any idiot who reads that bumper sticker..

[alp227]

36. I was about to bring this up, all you'll hear from Randall Terry, Jill Stanek, etc.

(crickets)

[unkachuck]

31. "...babies

...born in the U.S. have a higher risk of dying within the first month of life than babies born in 40 other countries."

....totally unacceptable for the most expensive, inefficient, corrupt, for-profit, health delivery system on the planet!

....our capitalists can't run a healthcare system, they can't run an economy and they certainly can't run a country....these fuckin' capitalists suck at everything....they're killing and destroying us slowly but surely....

....why do we put up with it?....we must be idiots....

[AikidoSoul]

33. The information in this thread is lost quickly by the MSM. They bury it after a day or so.

Nobody in the MSM beats the drum for child health. But how many times has that drum been beaten for reducing taxes for the super-rich?

[TexasProgresive]

34. Once they're born they're on their own.

Let them pull themselves up by their bootstraps. :sarcasm:

[onpatrol98]

37. That's just a shame...so sad.

[daleo]

39. Social inequality and infant mortality go together.

The U.S. is high on both by "rich" country standards.