Why is the Infant Mortality Rate High in the US?

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Many people were shocked when a 2006 report detailed that the US infant mortality rate ranked second highest in the world, among developed countries. Further, statistics regarding this rate showed disturbing patterns. The figure was much higher in the US among minorities, and was often connected not only to deaths for infants, but also health risks to mothers. Since the report, there have been a number of theories as to why the US infant mortality rate is so high, but access to health care, education, and information about pregnancy and birth control are likely contributors.

At the top of the list is inequitable access to health care, especially among those who are very poor and among teens who have children. Good medical advice and monitoring of a pregnancy is an important contributing factor to babies born at an appropriate birth weight, born full-term, and born healthy. There are poor people in all industrialized nations, but the US does not have any kind of nationalize health insurance plan that would help ensure that all women have access to the care they need. Countries with government health plans tended to have the lowest infant mortality rates.


Women who were of middle class or higher, and who had at least a high school diploma, were much more likely to have healthy babies. On the whole, the population most at risk for suffering the loss of a child is African-Americans, who are almost two times more likely to have a child either born dead or die within the first 24 hours after birth. While the average infant mortality rate in the US is 5 deaths per 1,000 births, for African Americans, this number climbs to nearly 10 deaths per 1,000 births.

Not only education, but the availability of birth attendants is a contributing factor. This is a surprising statistic, given that there are more obstetricians and neonatologists per person in the US than most other countries. Again, it likely comes down to access to these medical professionals and education regarding pregnancy and health care.

One of the other contributing factors cited is the availability and education about birth control. When this is available, as is the case in most of the countries with lower infant mortality rates, teenagers, one of the most likely groups to have pre-term labor, are less likely to become pregnant. This reduces the total group of women who might lose a baby born severely premature.

Along with the high rate of infant deaths in the US, there is also greater risk to mothers. Deaths during pregnancy climb with the infant mortality rate, translating to more risk to moms. This is especially the case when a mother does not deliver a child with a birth attendant.

What can be gleaned from studies like the one done in 2006 is that there are quite clear solutions to the problem. The country may be able to arrest the issue by learning from other nations and helping to ensure better care for American mothers and children.


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Post 29

Anon989969, your claim that the US has more stillbirths than other developed nations is mistaken. Per World Health organization statistics (from 2009), the US ranks Number 4 worldwide for lowest rates of stillbirth.

To compare "apples to apples" by totaling stillbirths and infant mortality in several other developed nations, you see the following numbers:

Iceland = 4.80 per 1000

Singapore = 5.46 per 1000

Finland = 6.34 per 1000

Germany = 6.44 per 1000

Switzerland = 6.68 per 1000

France = 7.41 per 1000

US = 8.35 per 1000

Australia = 8.46 per 1000

Canada = 8.87 per 1000

UK = 9.15 per 1000

US totals fit neatly in the middle of the pack.

Post 28

The myth about US infant mortality being due to "counting differences" is out in full force, I see. Why do all those countries that "do not count premature babies as live births" have fewer stillbirths than the US too?

Saving a premature baby is time-consuming and requires good equipment. And is very, very expensive. Premature birth is overwhelmingly represented among the lower socioeconomic layers. I.e. the people who are least likely to be insured or able to pay.

You are proposing that the US throws massive resources into a condition overrepresented among people who cant pay, to a degree where US stats end up exceeding not just some, but all the advanced countries where this financial disadvantage do not exist

. Where doctors are free to spend resources on children they think can be saved.

Also, how difficult is it really to get stats using the same definition from developed countries? Or make good conversions for professional statisticians? Hint: US infant mortality ratings are based mainly on reports using the WHO standard definitions.

And there are performance stats for US health care in general: Amendable mortality measures hospital errors. Average lifespan. Years lived in good health. Maternal mortality, how many mothers survive childbirth. Was that different counting too? Years lost to ill health. The US does badly in all of them. And the US does roughly equally badly in all of them. Infant mortality is no outlier.

That is probably why so many people leave the US for treatment and so few enter. 15 people leave for everyone who enters, and even that is hugely overblown by the number of people seeking cosmetic surgery.

It's like watching an obese person insist that its "metabolic." Hey, anything to avoid taking responsibility and trying to fix stuff.

Post 27

Does the US have the best healthcare in the world? Yes. Does every American get access to that high level of care? No. Bottom line: if you are wealthy or have good insurance, you will get the best; the rest, however, do not.

Those who think Medicaid offers the same quality of care as those with a premium insurance plan are kidding themselves. We pay more for worse outcomes, because we have one of the most inefficient health care delivery methods of the industrialized world. If you don't want to see your tax dollars go to see all Americans receive good health care, just admit you are selfish, and stop fooling yourself that America has the best for all.

Post 26

Having universal health coverage will not decrease the mortality rates for the U.S. because it is not about having coverage, but having enough brain cells to seek out the coverage.

When I was pregnant in 1996, I was considered an "at-risk" pregnancy. Single, no insurance, no job and a product of poor, black teen parents. However, I did get state assistance (Medicaid) and made sure I got my recommended maternity screenings (and I also got at least 2 or 3 ultrasounds). I took free childbirth classes and had an excellent team of doctors/nurses (along with my child's father and both of our families) to help deliver my child. I also made sure to not make another mistake and

burden society by having more children that I could not afford. (One child, only on Medicaid for one year after the birth of my child and haven't needed it since. My child is now 16.)

I have a lot of family members who continue to have pregnancies and not get the proper care. Not because they can't get the healthcare but because they don't want to go through the trouble again (some on their 4th, 5th 6th+ child).

So whose fault is that, the U.S.?

Post 25

Our healthcare system is second to none in the world. The doctors here are 100 times better than in Japan or France. People covered under private health insurance in America (73 percent of the country) have access to the best doctors, the most advanced technology, the most advanced procedures, and the most innovative research in the making.

The United States has the most people fly in from other countries to be treated because of our no. 1 healthcare. In fact, we quadruple the next best country. The reason for the high mortality rate is because we count infant mortality more harshly than other countries.

I believe someone had the correct statistics. Any socialized health system is too good to be

true. You pay 10 percent or more in taxes to be put on a wait list, receive mediocre care, and then be pushed out of the door to let the next patient in.

The only thing that the United States needs to do better is education (which is a government program). Women need to be educated about birth control and they also need to know the consequences of having sex. Using abortion for birth control is unacceptable and morally wrong, and I'm not even Christian.

A government takeover of healthcare is not a good idea. Anything created by the government is terrible, govt roads, schools. I mean just look at the DMVs. They look like crap. To you people who think universal healthcare is a right, I agree, but it's way too good to be true. By putting healthcare in government control you're ruining healthcare for the 73 percent who are covered.

Post 24

The real reason the USA ranks so "bad" is the definition of live birth is different than the rest of the world. In the USA, they consider babies born before 22 weeks a live birth, while in other developed countries they don't. They also don't count babies born under a certain weight as a "live birth" in other countries. The USA counts those as well. So counting those births and still only having two to four more deaths per 1,000 births is actually pretty good.

Post 23

So basically, you are saying because a child is born poor, not by their choice, that they should not be allowed to have children? I have used the system and yes, they helped with my childbirth, but I will tell you: the ones who could afford the cutting edge technology get better help. They will not even give you a sonogram on your child at the health department unless something is showing wrong with the heartbeat or the mother.

Everyone deserves equal health care. This is the future of our people and prenatal care and a healthy environment and being able to live without fear of no income because you want to create a family, even though you are not rich, should be allowed. It starts in the womb. A healthy mother creates a healthy womb and her child will create one for her child. You make valid points, but you are very one sided with your thoughts.

Post 22

The U.S. has the best health care in the entire world and I challenge anyone to show me that is not accurate. Access to health care is not the same thing as quality of health care. We have the most highly trained and skilled doctors, researchers and other medical professionals in the world. We have the cutting edge technology in strokes, cancer treatment, neurological disorders, etc.

A woman choosing not to seek prenatal care should not reflect on the mortality rate. The truth is, more women in the U.S. carry their pregnancies to term rather than aborting when they find out the child will have a minor or major defect like in many countries. We have clean water, nutrition

, vaccinations, etc. Every child has insurance coverage – every one, either through their parents or through the government, there are no uninsured children. Prenatal care is available at low or no cost for low income women. Choosing not to use it is not the fault of "the system".
Post 21

This is a poor explanation for the US infant mortality rate. We have free health care for all mothers who need it, e.g., CHIPS. The fact also is we bring more infants to term than any other nation due to our excellent health care. Are you kidding me? Cuba is better ranked than the USA. That is simply WHO health care bad mouthing.

Folks, they do not like us and will manipulate the figures to ensure we look bad. Check out the Cleveland Airport for planes from all over the world going to the Cleveland clinic for care. Any planes in Cuba?

Post 19

Given a choice of having your baby delivered in the USA or France, where would you choose? Easy answer: USA

Post 18

I would like some straight talk. There is no mention of the mothers who murder and neglect their children. That has nothing to do with health insurance. There are plenty of clinics available for care.

It's instinct to care for your child. There are no children dying in this country because a doctor refused to care for them. There are children who die from the neglect of their so-called parents, though.

Post 17

U.S. health care is the world's best. I've lived in the states, and I've lived abroad in a socialized system. The socialized systems are garbage. You are garbage in such a system, and they have no qualms leaving you to rot and die. You pay a mint in taxes for garbage "care".

People die on waiting lists. Treatments and drugs are outdated, or there is no access to them. Care is most certainly rationed. Old people are put out to pasture to die. I was horrified how poor the health care is in the countries peddled by the American Left as examples. Americans, learn to read another language or use google translate. Start accessing foreign blogs, and read for yourself

how cruel people are treated. How they commit suicide, etc. It's a nightmare.

I have always been an independent politically, but after the experience I've had, I will never vote the American Left. Never. Liars and murderers run socialized states.

Post 16

America has the worst health care of the developing nations. Everybody who doesn't with it is either selfish or an idiot, or both. I wonder how many selfish people/idiots/selfish idiots are out there.

Post 15

The OECD has had a footnote on the incompatibility of its infant mortality statistics for years. anon41646 has it exactly right.

Countries have different definitions of live birth, and therefore infant mortality statistics are not comparable.

No one who makes assumptions about international comparisons of infant mortality statistics and then proceeds to bash US health care with them can be considered an expert. This stuff has been well known since the mid 1990s.

Post 14

If we are talking about personal responsibility, why are we not spending more on educating women and men about birth control and family planning in general?

We focus so much on who should pay for health care for "poor people" for prenatal care, yet I almost never hear anything about the fact that we almost seem to be supporting poor families having children they cannot afford. We continue to try to solve the problems of low income people receiving help with health care, food, shelter, etc. for their families by throwing more money and resources their way.

People have a responsibility to not create children they cannot support! I managed to not have any babies because I knew I couldn't

care for them as well as I should be able to. I am a product of teen parents who were very poor, and made sure to use birth control throughout high school and my young 20's. I even obtained birth control quite easily through Planned Parenthood, which was free when I couldn't afford it.
Post 13

It seems the people against universal health care don't care about the facts.

The fact is the earlier and better prenatal care a pregnant woman receives the less likely she will go into preterm labor and therefore more likely for her baby to survive. She will receive that care if it is covered, but not if she has to pay out of pocket. this leaves the poor uninsured to be more likely to have their baby die because they did not receive good prenatal care.

And these are the same people that are pro-life? Pro-lifers should be for anything that would improve survival rates of newborns, shouldn't they? Oh wait, but not if they have to pay higher taxes to help their fellow humans. Selfish jerks is what they are plain and simple.

Post 12

@anon41646: stop your right wing rhetoric. Denying people the same quality health care is inhumane and utterly lacking in sense and compassion. Stop watching Faux news and Glenn Beck and allow your heart to grow. I can't believe that other mothers could be so heartless.

@anon44912- There are these things called Amendments. I guess we should reinstitute slavery and take the vote away from women.

I cannot believe the number of short-sighted and uneducated posts here.

Medicare does not provide you with the same medical care as having health insurance. Plus people in lower socio-economic groups are usually less educated, have less access to important information and are less likely to seek medical care.

Yes, the babies are born in hospitals but they do not get the same prenatal care. Prenatal care is an essential component to having a healthy baby and birth, not just the birth. Diet can have a huge impact on birth outcomes, particularly in preventing preeclampsia.

Post 11

It's strange that there's not enough access to health care in America when 98 percent of births are in a hospital.

You tell me what's wrong with this logic.

Post 10

I live in England (I am American) and everyone has health care here, no matter what you earn. That is a great thing to have especially in this day and age when you don't know if you are going to be out of work. It disgusts me to know how 'great' a country we have but not everyone can see a doctor when needed. I think that we have our priorities wrong and agree, we are too busy chasing materialistic stuff than taking care of people.

Post 9

This article is not about universal health care. It is about high infant mortality rates. I think the Faux News drones have now lost their minds.

The fact of the matter is this. Insured, uninsured, or not, our country is one in which we use more invasive procedures during delivery than other countries. In most other countries, most women don't see OB/GYNs right out the gate, they typically see a midwife and then if complications arise, they are referred to an OB/GYN.

Most other countries tend to have lower premature birth rates as well, and this can be attributed to the fact that most people have access to health care and birth control. Teens here have a hard time obtaining

birth control, and in my great state are taught abstinence only, which explains our high teen pregnancy rate.

We also have a higher C-section rate than the rest of the world. C-sections tend to be riskier than natural child birth. In Europe they have access to certain birth controls and fertility techniques that we don't here.

They have scientists in other parts of the world as well. I would also like to see proof that in other parts of the developed world, they just let babies die. They just let my baby die here in America and I was insured on my own plan, because in reality, trying to revive a 20 week baby is unrealistic. Most doctors won't do anything until 24 weeks. That is science, not people letting babies die.

America does not count miscarriages as infant death. An eight week miscarriage is not considered infant mortality.

Not all poor people are poor enough for medicaid, and not all insurance covers pregnancy.

If you want facts, please provide them, instead of the nonsense you heard on Glenn Beck or Rush Limbaugh. This site was about infant mortality, and you brought politics into it.

Post 8

and yet i was denied healthcare here in the great nation.

Post 7

no, no. this is just dealing with reasons for death of babies. the reason however should be blamed on the individual. everyone i know has had awesome prenatal care.

america has awesome prenatal care and technology, just a lot of citizens don't use it. just like we know we can eat healthy foods from all around the earth and we choose McDonalds.

Post 6

At what point do we take responsibility for ourselves? We have the highest teen pregnancy rate in industrialized nations, not because of the lack of more welfare and birth control, but because we are morally bankrupt and families are so busy chasing stuff and ignoring their own family.

Those who believe more welfare and a government health care program will fix our families are sadly mistaken.

In addition, the US leads the way in fetal surgery and saving early gestation babies that other countries would consider a "spontaneous abortion."

Post 5

As a health educator and a director of an infant mortality program in my state, I can tell you first hand there are millions of reasons that the rate is so high in America. This is a fact: not everyone can receive medicaid if they are poor. The income criteria for medicaid is set at an amount where some low-middle class families don't qualify.

Being insured is a problem because if they aren't insured they can't not be monitored and educated throughout their pregnancy to ensure a healthy outcome.

But insurance isn't the only piece of the puzzle. Lack of education, transportation in rural communities and lack of government programs play a key role in this rate. No it may not be your job to pay for someone's health care but aren't we paying for your social security benefits in the future? So what's the difference?

Post 4

As a health care worker I have watched doctors contribute to the infant mortality rate. They use every opportunity they can to interfere with normal labor and birth, causing their own negative statistics. Having participated in over 2,000 deliveries myself, I learned that if you leave the natural process of birth alone it will usually progress normally with little or no incident, but introduce drugs such as an epidural, labor augmentation or cesarean, birth becomes a medical nightmare of intervention upon intervention. I think the motivation is money as each of these interventions have a CPT code and cost associated with them. In America roughly 98 percent of births take place in hospitals and we have one of the worst infant mortality rates of any industrialized nation. So who do you think is responsible for the horrendous stats?

Post 3

I just read the constitution again. There is no mention of a fundamental right to health care paid for by your neighbors. Besides, it is absolutely nonesense that the poor don't get health care. Medicaid is available to *all* poor children. If you are suggesting the poor are doing worse in this country, maybe that's a sign that Medicaid (a government program) is the problem.

Post 2

yet if prenatal care matters and it clearly does, no doctor has to provide it, unless it is on an emergency basis, and the pregnant woman in an emergency situation still gets a bill, even if she gets care, that she cannot pay, leaving some women to choose home birth without any qualified medical assistance. But the issue of poor prenatal care especially among the poor, where problems are evaluated throughout a pregnancy is crucial, and that need is not being met. I think you are opposed to universal health care, and yet, it should be noted that infant mortality rates in many countries that have varying forms of government care are much lower than US statistics. I would be on the side of any policies that would view health care as a fundamental right that helps to pursue all other rights the constitution grants.

Post 1

This article reads like a propaganda piece for universal health care. There are a number of other very important factors that contribute to higher infant mortality rates in the U.S. First, the U.S. is far more successful at delivering premature babies - other "industrialized countries" don't deliver nearly as many as we do per capita nor do they spend anywhere close to what we do on such infants. They just let them die. Second, the U.S. is much farther ahead in terms of various fertility enhancing techniques, resulting in far more preemie births, driving up the number of premature multiple births which, due to their risk, have a much higher death rate. The stats don't take into account

miscarriages, which is how many of these other countries count the deaths that we would call infant deaths because we get more of them out of the womb alive, but more of them die. Finally, it's completely inaccurate to say we don't "guarantee health care" in the U.S. First, all poor people are eligible for Medicaid and second, by law (passed in 1969) no health care provider can deny lifesaving care to anyone based on their inability to pay. I can't believe this drivel is being peddled on a so-called "expert" site. Stop flacking for the Democrats, please and just give us the facts.

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