Wednesday, May 10, 2006

And Even More On the American Malady

The United States is not leading the world in the health of its newborns:

America may be the world's superpower, but its survival rate for newborn babies ranks near the bottom among developed nations.

Among 33 industrialized nations examined in a new report, the United States tied with Hungary, Malta, Poland and Slovakia with a death rate of nearly 5 per 1,000 babies. Only Latvia had higher mortality figures, with 6 per 1,000, according to the report by the U.S.-based Save the Children.

"We are the wealthiest country in the world, but there are still pockets of our population who are not getting the health care they need," said Mary Beth Powers, a reproductive health adviser for Save the Children, which compiled the rankings based on health data from countries and agencies worldwide.

The report was released Monday, ahead of Mother's Day.

Researchers noted that the United States is more racially diverse and has a greater degree of economic disparity than many other developed countries, making it more challenging to provide culturally appropriate health care.

The report, which was released Monday, also said a lack of national health insurance and short maternity leaves likely contribute to the poor U.S. rankings.

Other possible factors in the U.S. include teen pregnancies and obesity rates, which both disproportionately affect African-American women and also increase risk for premature births and low birth weights.

This is not news, really. The U.S. neonatal death rate has been high for an industrialized nation as long as the statistics have been available, and the difference is almost totally because of the experience of African-Americans. As this article notes, the African-American neonatal death rates are comparable to those found in developing countries.

The reasons for the high death rates are similar, too: poverty and bad nutrition, lack of access to regular antenatal care and teenage pregnancies. Teenagers tend to have much smaller babies and smaller babies are more likely to die.

Some solutions to this problem would not be expensive, if the political will for them could be found. Antenatal clinics have been found to work really well, and starting some in poor areas would do marvels. Of course they'd have to be free. But currently even the programs that have been shown to be effective are under the threat of termination, because the administration does not believe in government intervention in anything but warfare and laws to protect property rights.

The interest in neonatal mortality statistics is not just because of the human importance of the problem but also because this measure is seen as one which is very amenable to health care solutions, and high numbers mean that the health care system is not functioning very well. We know, by and large, what the feasible minimum number of deaths is today (close to the Japanese 1.8 per thousand live births), and we know that we could push the African-American neonatal death rate (9 deaths per thousand live births) to that level with pretty much nothing else than good antenatal care and nutrition supplementation. Think of that.