Why Does The US Appear to Have Higher Infant Mortality?

I am sure you have seen various rankings where the US falls way behind other western nations in terms of infant mortality.  This stat is jumped on by the left as justification for just how cold and heartless America is, and just how enlightened socialized medicine must be.  However, no one seems to bother to check the statistic itself (certainly the media is too incompetent to do so, particularly when it fits their narrative).  Statistics like this that are measured across nations are notoriously unreliable, as individual nations may have different definitions or methods for gathering the data.

And, in fact, this turns out to be the case with infant mortality, a fact I first reported here (related post on medical definitions driving national statistics here).  This week, Mark Perry links to an article further illuminating the issue:

The main
factors affecting early infant survival are birth weight and
prematurity. The way that these factors are reported "” and how such
babies are treated statistically "” tells a different story than what
the numbers reveal.  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 less than 500 kg 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....

In the United States, all infants who show signs of life at birth
(take a breath, move voluntarily, have a heartbeat) are considered
alive.

If a child in Hong Kong or Japan is born alive but dies within the
first 24 hours of birth, he or she is reported as a "miscarriage" and
does not affect the country's reported infant mortality rates....

Efforts to salvage these tiny babies reflect this classification. Since
2000, 42 of the world's 52 surviving babies weighing less than 400g
(0.9 lbs.) were born in the United States.

Hmm, so in the US we actually try to save low-birthweight babies rather than label them unsalvageable.  Wow, we sure have a cold and heartless system here.  [disclosure:  My nephew was a very pre-mature, very low-birthweight baby who could have fit in the palm of your hand at birth and survived by the full application of American medical technology.  He is doing great today]

  • Tony Edwards

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

    But it would have a very dead mother!

  • http://www.buffalog.blogspot.com Craig

    "a premature baby weighing less than 500 kg is not considered a living child"

    The elimination of all babies weighing less than 500 kilograms would result in startling numbers, indeed.

  • Craig

    Several other factors are involved:

    Because of superior pre-natal care, a much higher percentage of troubled pregnancies result in a birth than in countries like Cuba, where the mother would simply miscarry.

    Because of our national wealth and superb health system, potential US mothers can routinely get infertility treatments, which often result in multiple, usually premature, births. In poor countries, or those with extremely low birth rates (Italy 1.33; Spain 1.32; Greece 1.29) there are far fewer multiple births as a result of fertility treatments.

    The US has far more young, prospective, mothers illegally entering its borders. Regardless of how you feel about immigration, these women will have more troubled pregnancies than will older women living legally in a country.

  • http://chrisyeh.blogspot.com Chris Yeh

    What, another way in which the Euros aren't actually better than America? Color me shocked. Next thing you know, you'll tell me that America produces more innovation and value.

  • Mark

    The Left uses statistics like this to confuse the masses. The other statistic that they use to "prove" the superiority of the European system is "Life Expectency", as if health care is the only component in determining life expectency.

    What they NEVER talk about is actual outcomes. For example, in the infant mortality discussion they never discuss the differing outcomes for low weight children in the US and Europe.

    Other examples are comparing survival rates of cancer and other diseases, like the five year survival rate of prostate cance is 99.3% in the United States compared to 77.5% in the socialized European countries.

    Or they never discuss the waiting times (which impacts the above survival rates) for treatment. What this means is that in the socialized systems you PAY for your low cost health care coverage by suffering pain. Instead of your grandparents getting their knee replaced when they need to they will have to suffer for six to eight more months of chronic pain. What is the value of that?

  • Rocky Mountain

    Just a small digression about national healthcare systems...I lived in the UK for a while (my wife is British) and was diagnosed with a hernia, albeit, my local GP could not do it three times and I had to be seen by a specialist who spent about 10 seconds before arriving at a correct diagnosis). I was duly scheduled for surgery (Gulp!) and waited. We returned to the States and I saw a doctor here for the same thing. Four days later I was out of the hospital having had successful surgery. Sometime after that I had a letter from Britain's National Heath Service (NHS) informing me that I was still on the waiting list (over a year later) and I would be hearing from them again. I never did.

  • Rocky Mountain

    Just a small digression about national healthcare systems...I lived in the UK for a while (my wife is British) and was diagnosed with a hernia, albeit, my local GP could not do it three times and I had to be seen by a specialist who spent about 10 seconds before arriving at a correct diagnosis). I was duly scheduled for surgery (Gulp!) and waited. We returned to the States and I saw a doctor here for the same thing. Four days later I was out of the hospital having had successful surgery. Sometime after that I had a letter from Britain's National Heath Service (NHS) informing me that I was still on the waiting list (over a year later) and I would be hearing from them again. I never did.

  • gmsc

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

    For those of you not use to metric, 500 kg is over 1,100 imperial pounds, or a little over half a ton. You'd think most European countries could save babies weighing 1,100 lbs, but maybe we're more advanced in the US than we think.

  • SR

    By kg he means g, I assume?

  • http://thesciphishow.com Jason

    Such misleading statistics. Oh well.

    It is great that the US has such amazing technology and goes out of its way to attempt to save those born prematurely.

    The part I find troubling is that nobody bothers to count those killed by their mothers because they were not convenient.

  • Dr. T

    The discrepancies in infant mortality reporting go back decades. I have always taught my medical students and residents to ignore the infant mortality statistics from other countries. We use the strictest possible interpretation of neonatal and infant deaths. If a markedly premature baby has a heartbeat and takes a breath before dying minutes later, that is an infant death. In almost every other country it would be classified as a miscarriage or a stillbirth.

    When you normalize the data, the U.S. still does not have the lowest infant mortality. The factors mentioned by Craig above are major reasons. Another is that we have subpopulations, mostly among our black and hispanic groups, that shun medical care, including prenatal care. This lack of prenatal care greatly increases infant mortality.

  • Anonymous

    Clearly, it's not 500 Kg, but 500 grams.
    Note that 500 grams is about 1.1 pounds.
    A typical baby weights 1.1 pounds at 23 weeks.
    At 20 weeks, a baby weights about 300 grams, or 0.66 pounds. Past 20 weeks is considered late-term.
    1% of abortions happen after week 20 ("late-term" abortions). This is about 16,000 each year.

    It seems to me that in the U.S., a baby is considered viable at 20 weeks, even though its viability is slim at best. In other countries, viability seems to be considered at 23 weeks. The interesting fact though, is that those 16,000 abortions that happen after week 20 are probably counted towards the infant mortality rate in the U.S..

    In 2005, there were 4,138,349 births in this country. Assuming that the rates have not changed significantly, the mortality rate in the US is about 6.3 per 1,000 births, or about 260,000. A whopping 6% of those deaths may be attributed to late-term abortions. Of course, I am also assuming that the U.S. does not count abortions before 20 weeks as live births.

    http://www.abortionno.org/Resources/fastfacts.html
    http://www.infoplease.com/ipa/A0005067.html
    http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate

  • http://vox-nova.com Blackadder

    Here is what appears to be the original article excerpted in this blog post. As you can see, in the original "<500g" is used rather than "less than 500kg." How the two got switched up I don't know.

  • Mesa Econoguy

    500kg birth weight would seemingly cause a higher infant mortality rate.

    Perhaps enhanced gravity field?

  • bristlecone

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

    Holy shiznit! Remind me to stay out of those countries! I only weigh 120 KG, and would probably be buried there!

  • Mesa Econoguy

    Global warming

  • DKH

    Blackadder:

    I would think that it is likely a correction. Mark Perry's blog on this subject also contains the same "500 kg" error:

    http://mjperry.blogspot.com/2008/08/infant-mortality-measurements-not.html

  • Methinks

    This is a great post. Las Friday, 20/20 did a whole show on infant mortality in Memphis - lamenting that "we have one of the highest infant mortality rates in the developed world". Spare me. The whole one hour show was designed to show that nobody cares about 12 year old black mothers who don't bother to go for pre-natal care at the free clinic and who are giving birth to four month old fetuses and we're letting them rot as if they're in a third world country. Never mind that in the third world, many of those girls wouldn't have made it to the ripe old age of 12! It was an hour of the most annoying television.

  • Tariq Mahmood

    Dr. T's math is wrong, apparently we all have trouble with math at times.

    6.7 babies dying per 1000 live births is 0.67%.

    with 4.2 million births, 0.67% of that is 0.024 million deaths, or 24,000 deaths. If 6% of babies died then yes 240,000 would dying every year.

    In Afghanistan where Infant Mortality is estimated at over 15% around 240,000 babies die every year.

    It is sad really and not enough is being done by Afghanis overseas to change that.