21

Wasn't sure how to phrase that title, but in a comment on this article, someone stated that

The US ranks 30th in child birth mortality; 30th, not 5th or even 7th, 30th, behind most of Europe, Israel, Japan, and clearly 20+ other countries.

and was responded to with this

Yes, and this is in part because these countries have different definitions of what constitutes “perinatal mortality”. The US classifies as stillbirths what other countries would not.

Is this really true? Does the US rank lower/worse on measures of infant survival because it define "infant mortality" differently from other countries?

  • Is that comment saying the US has the 30th-highest or 30th-lowest child birth mortality rate? – Max Nanasy Aug 31 '18 at 14:50
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    @MaxNanasy 30th-lowest. – Michael A Sep 2 '18 at 12:50
25

There is an article from the CDC on this titled "Behind International Rankings of Infant Mortality: How the United States Compares with Europe". They show the different reporting requirements, and the US is indeed one of the countries with the strictest reporting requirements. But 14 out of 19 European Countries have the same reporting requirements as well.

The authors then compare only births after 22 weeks of gestation, which eliminates the differences in reporting between countries. The graph then looks like this:

enter image description here

This is a lower rate than the uncorrected one, but still significantly higher than most European Countries.

The authors also explicitly state that the reporting differences are unlikely to be the cause of the low international ranking of the US:

In 2005, the United States ranked 30th in the world in infant mortality, behind most European countries, Canada, Australia, New Zealand, Hong Kong, Singapore, Japan, and Israel. There are some differences among countries in the reporting of very small infants who may die soon after birth. However, it appears unlikely that differences in reporting are the primary explanation for the United States’ relatively low international ranking.

The study further notes that:

The main cause of the United States’ high infant mortality rate when compared with Europe is the very high percentage of preterm births in the United States

  • 5
    One factor that seems to be overlooked for analysis is, are there differences in countries neonatal and abortion standards (e.g. would the same baby be declared "likely won't survive, just do an abortion" in Europe yet allowed to try to survive in USA, due to cultural differences); and also - less likley but possible - differences in ability to save a preemie at birth (e.g. in USA there may be more heroic efforts to save babies that would soon die anyway). – user5341 Sep 12 '14 at 16:22
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    Another factor that would be interesting to analyze would be mothers' age and ideally health. Since the biggest factor the study uncovered was the age when preemie was born, those may be important root causes which have nothing to do with "an important indicator of the health of a nation" as the study puts it. – user5341 Sep 12 '14 at 16:26
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    The gap between the homogenous nordic (Sweden, Norway, Finland) and Denmark is weird and more curious than the US vs Europe. – Kit Sunde Apr 14 '15 at 7:51
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    It would be interesting also to see how this is distributed throughout the U.S., both geographically and demographically. I wouldn't be surprised to see much higher rates in the areas with lots of recent (and not always legal) immigrants near the Mexican/American border, for instance. I'd also imagine that illegal immigrants would be less likely to seek medical assistance for fear of deportation and, thus, outcomes would suffer. Such higher-risk groups constitute a much larger share of the population of the U.S. vs. most European nations, so that alone might explain a lot of the difference. – reirab May 6 '15 at 5:08

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