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.