The news: Infant mortality is an important indicator of development and quality of life associated with important factors such as medical care, public health and socioeconomic conditions. But while infant mortality might be on the decline throughout the world, the situation in U.S. is far from good.
In a disconcerting new report, the Centers for Disease Control and Prevention (CDC) found that among the 28 wealthiest nations in the world, the U.S. ranks worst when it comes to infant mortality rates. Globally, the U.S. ranks in 51st place, comparable to Croatia, and has triple the rate found in developmentally similar countries such as Finland and Japan.
And some states are worse off than others: "If Alabama were a country, its rate of 8.7 infant deaths per 1,000 would place it slightly beyond Lebanon in the world rankings. Mississippi, with its 9.6 deaths, would be somewhere between Botswana and Bahrain," the Washington Post reported.
"I think we've known for a long time that the U.S. has a higher preterm birth rate, but this higher infant mortality rate for full-term, big babies who should have really good survival prospects is not what we expected," study lead author and CDC statistician Marian MacDorman told HealthDay.
It's no coincidence Finland is doing so well. As previously reported by Mic, Finland has been lauded for its maternity and prenatal care programs. And all you have to do is take a look at its famous "baby boxes" to see why.
In 1938, the Finnish government started giving out a starter kit of sorts to low-income expectant mothers, filled with baby clothes, sheets and more. Eleven years later, the gift was extended to all pregnant Finnish women. These supplies, along with mandated, free visits to prenatal clinics before entering the fourth month of pregnancy, drastically improved infant health.
While Finland's maternity-box program might not be the sole contributing factor to this decline, it does symbolize the country's investment in maternal health. In the 1960s, Finland created a national health insurance system and central hospital network, which likely also help decrease infant mortality.
There are also socioeconomic issues at play. Recent research from University of South California, University of Chicago and MIT has attempted to uncover why the U.S infant mortality rate is so high. While improvements in preterm birth care is one factor — more preterm babies are being saved, but they might not survive due to complications — the researchers noted socioeconomic disadvantage plays a huge role in infants' chance for survival.
"We document that the US postneonatal disadvantage is driven almost entirely by excess mortality among individuals of lower socioeconomic status. We show that infants born to white, college-educated, married women in the U.S. have mortality rates that are essentially indistinguishable from a similar advantaged demographic in Austria and Finland," the researchers wrote.
At every level of education, infant mortality for black mothers is twice that of white mothers. The same goes for maternal mortality: Death from pregnancy or birth is three times as likely for black women than white women, making U.S. one of the only countries where maternal mortality is actually increasing. And on top of the racial disparities, income inequality plays a major factor in the varying infant mortality rates, especially in the U.S.
Despite efforts like Obamacare to improve prenatal and maternal care, infant and maternal mortality are likely to remain high until socioeconomic factors that disadvantage certain groups of women are actually addressed. While improvements in the U.S. healthcare system under the Affordable Care Act have certainly made strides in providing more low-income people with better health care and coverage, the U.S. continues to have the worst healthcare system among comparable, wealthy countries. All these problems hit poor people much harder, and infant mortality is no exception.
"The U.S. lags behind other developed countries because there remain significant gaps in access to and utilization of prenatal and preconception care," Dr. Deborah Campbell, a professor of clinical pediatrics at Albert Einstein College of Medicine, told HealthDay. "There is a well-delineated history of racial and ethnic disparities in maternal and infant outcomes in the U.S., with black women and their infants being at greatest risk and having the highest rates of poor outcomes."
If infant mortality is a true indicator of development and quality of life, it shows the U.S. has a long way to go.