Chicago Tribune: The truth on infant mortality
The American medical system has the latest technology, the greatest variety of new drugs and unparalleled resources. But anyone who thinks we're getting something great for our dollars inevitably encounters a two-word rebuke: infant mortality.
The United States is the richest nation on Earth, but it comes in 29th in the world in survival rates among babies. This mediocre ranking is supposed to make an irrefutable case for health-care reform. If we cared enough to insure everyone, we are told, we would soon rise to the health standards of other modern nations. It's just a matter of getting over our weird resistance to a bigger government role in medical care.
But not every health issue is a health-care issue. The reason boxers are unusually prone to concussions is not that they lack medical insurance. Doctors may treat head injuries, but it's a lot easier to prevent them. Absent prevention, we shouldn't blame the medical industry for punch-drunk fighters.
Like life expectancy (the subject of a previous column), infant mortality is a function of many factors. The more you look at the problem, the less it seems to be correctable by a big new federal role in medical insurance -- and, in fact, the less it seems to be mainly a medical issue at all.
No one denies the problem. Our infant mortality rate is double that of Japan or Sweden. But we live different lives, on average, than people in those places. We suffer more obesity (about 10 times as much as the Japanese), and we have more births to teenagers (seven times more than the Swedes). Nearly 40 percent of American babies are born to unwed mothers. ...
...African-American babies are far more likely to die than white ones, which is often taken as evidence that poverty and lack of health insurance are to blame. That's entirely plausible until you notice another racial/ethnic gap: Hispanics of Mexican or Central or South American ancestry not only do consistently better than blacks on infant mortality, they do better than whites. Social disadvantage doesn't explain very much. ...
...So why does our infant mortality rate exceed that of, say, Canada, where health care is free at the point of service?
One reason is that we have a lot more tiny newborns. But underweight babies don't fare worse here than in Canada -- quite the contrary. ...
The United States is the richest nation on Earth, but it comes in 29th in the world in survival rates among babies. This mediocre ranking is supposed to make an irrefutable case for health-care reform. If we cared enough to insure everyone, we are told, we would soon rise to the health standards of other modern nations. It's just a matter of getting over our weird resistance to a bigger government role in medical care.
But not every health issue is a health-care issue. The reason boxers are unusually prone to concussions is not that they lack medical insurance. Doctors may treat head injuries, but it's a lot easier to prevent them. Absent prevention, we shouldn't blame the medical industry for punch-drunk fighters.
Like life expectancy (the subject of a previous column), infant mortality is a function of many factors. The more you look at the problem, the less it seems to be correctable by a big new federal role in medical insurance -- and, in fact, the less it seems to be mainly a medical issue at all.
No one denies the problem. Our infant mortality rate is double that of Japan or Sweden. But we live different lives, on average, than people in those places. We suffer more obesity (about 10 times as much as the Japanese), and we have more births to teenagers (seven times more than the Swedes). Nearly 40 percent of American babies are born to unwed mothers. ...
...African-American babies are far more likely to die than white ones, which is often taken as evidence that poverty and lack of health insurance are to blame. That's entirely plausible until you notice another racial/ethnic gap: Hispanics of Mexican or Central or South American ancestry not only do consistently better than blacks on infant mortality, they do better than whites. Social disadvantage doesn't explain very much. ...
...So why does our infant mortality rate exceed that of, say, Canada, where health care is free at the point of service?
One reason is that we have a lot more tiny newborns. But underweight babies don't fare worse here than in Canada -- quite the contrary. ...
From an earlier article by Chapman on Life Expectancy:
One big reason our life expectancy lags is that Americans have an unusual tendency to perish in homicides or accidents. We are 12 times more likely than the Japanese to be murdered and nearly twice as likely to be killed in auto wrecks.
In their 2006 book, "The Business of Health," economists Robert L. Ohsfeldt and John E. Schneider set out to determine where the U.S. would rank in life span among developed nations if homicides and accidents are factored out. Their answer? First place.
I also recently saw (can't find the article) that life expectancy for Americans at about age 50 and higher is about a year or more longer than in other developing nations.
Comments