Periodically in discussions of health care reform and spending, unfavorable comparisons are made between the USA and countries around the world. Turn to the CIA World Factbook, and we see that the United States lagged 45 spots behind Singapore and other nations in infant mortality. Shameful, isn’t it? Here we are, the self-professed greatest country on earth, the shining beacon of hope, and yet we are straggling in what is considered to be a general marker of a country’s progress towards civilization by the UN.
However, where are the numbers coming from?
According to UN guidelines (followed by the US), “live birth is the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which after such separation breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, of definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached. Each product of such a birth is considered live-born regardless of gestational age.”
Pretty cut and dry, and it doesn’t leave much room for creative interpretation. You’ll note that this includes extremely premature infants, babies that never take a single breath, and babies that are only alive (by the above criteria) for a few seconds. It also fails to exclude undersized infants.
For those who are reading on, the first of them comes from a conservative think tank, but it made valid points. The second is an article from UNICEF (from 2003) questioning the validity of mortality numbers posted from Central and Eastern European nations. The third is a list of definitions of live birth from multiple countries.
According to the links above, one country may automatically define a 25 week baby that dies in 3 days an abortion/miscarriage (that, incidentally, is denied intensive care and support) and another may devote enormous resources to help a 22 week infant survive and, sadly, fail. That certainly seems to stack the data against the second country when numbers are submitted at the end of the year.
I’ll briefly touch on another matter – the definition of an infant. According to the UN guidelines linked to earlier in this article, the time between live birth to one year of age defines an infant. There has been some question of manipulation of age at time of death with older infants in some countries, in which case the mortality is reported but pushed into the post-infant category. This would be interesting to pursue further, but I will leave more strenuous fact checking and searching for another discussion.
I’m interested in seeing what everyone has to say. I get very tired of attacks on American health care in general, so it’s nice to get an article out on ON.
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