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Best health care in the world?

AJHawkfan

Wanna make $14 the hard way?
http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/index.html

U.S. has second worst newborn death rate in modern world, report says
Research: 2 million babies die in first 24 hours each year worldwide

By Jeff Green CNN

Tuesday, May 9, 2006; Posted: 3:44 p.m. EDT (19:44 GMT)

(CNN) -- An estimated 2 million babies die within their first 24 hours each year worldwide and the United States has the second worst newborn mortality rate in the developed world, according to a new report.

American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland or Norway, Save the Children researchers found.

Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the United States, which is tied near the bottom of industrialized nations with Hungary, Malta, Poland and Slovakia with five deaths per 1,000 births.

"The United States has more neonatologists and neonatal intensive care beds per person than Australia, Canada and the United Kingdom, but its newborn rate is higher than any of those countries," said the annual State of the World's Mothers report.

The report, which analyzed data from governments, research institutions and international agencies, found higher newborn death rates among U.S. minorities and disadvantaged groups. For African-Americans, the mortality rate is nearly double that of the United States as a whole, with 9.3 deaths per 1,000 births.

Sub-Saharan Africa remains the worst place in the world to be a mother or child, with Scandinavian nations again taking the top spots in the rankings by the Connecticut-based humanitarian group.

Sweden heads the list, with Niger last.

The "Mothers' Index" in the report ranks 125 nations according to 10 gauges of well-being -- six for mothers and four for children -- including objective measures such as lifetime mortality risk for mothers and infant mortality rate and subjective measures such as the political status of women.

Charles MacCormack, president and CEO of Save the Children, said the report card "illustrates the direct line between the status of mothers and the status of their children."

"In countries where mothers do well, children do well," he said in a written statement accompanying the report.

But each year, according to the report, more than a half-million women die as a result of pregnancy and childbirth difficulties, 2 million babies die within their first 24 hours, 2 million more die within their first month and 3 million are stillborn.
An unhealthy start

As Americans celebrate Mother's Day on Sunday, "5,000 mothers will mourn the loss of the newborn they bear that very day in the developing world," said Anne Tinker, director of Save the Children's Saving Newborn Lives initiative.

"All children, no matter where they are born, deserve a healthy start in life," Melinda Gates wrote in a foreword to the report, which was funded in part by the foundation she runs with her husband, Microsoft co-founder Bill Gates.

MacCormack said "significant progress" had been made in reducing deaths in children under age 5 in recent years, but "we have made little progress in reducing mortality rates for babies during the first month of life."

Causes of death in the developing world were dramatically different from those in the developed world, the report said. In industrialized nations deaths were most likely to result from babies being born too small or too early, while in the developing world about half of newborn deaths were from infection, tetanus and diarrhea.

The newborn mortality rate in the United States has fallen in recent decades, the report said, but continues to affect minorities disproportionately.

Only 17 percent of all U.S. births were to African-American families, but 33 percent of all low-birthweight babies were African-American, according to the report.

The research also found that poorer mothers with less education were at a significantly higher risk of early delivery. The study added that in general lower educational attainment was associated with higher newborn mortality.

Tinker said Japan was among a number of nations highly ranked mainly because they offer free health services for pregnant women and babies, while the United States suffers from disparities in access to health care.

"We can do better here, but what's really important is that we do something" in the developing world, she said.

The report said almost all newborn and maternal deaths take place in developing nations -- 99 percent and 98 percent, respectively. The newborn mortality rates were particularly high in countries with a recent history of armed conflict, including Liberia and Sierra Leone.

But the report also concluded that political will was more important than national wealth. A "newborn scorecard" ranking 78 developing nations found that some relatively impoverished countries -- including Colombia, Mexico, Nicaragua and Vietnam -- fare better than others.

Ranking at the bottom of the scorecard were Liberia, Afghanistan, Angola and Iraq -- countries where armed conflict and cultural practices impede newborn survival.

"It's tragic that millions of newborns die every year, especially when these deaths are so easily preventable," Gates wrote. "Three out of four newborn deaths could be avoided with simple, low-cost tools that already exist, such as antibiotics for pneumonia, sterile blades to cut umbilical cords and knit caps to keep babies warm."
'The good news'

The Mothers' Index -- which excluded some nations that lacked sufficient data -- highlights huge disparities between the nations at the top and the bottom of the list.

Compared with mothers in the top 10 countries, a mother in the bottom 10 was found to be more than 750 times more likely to die in pregnancy or childbirth.

In top-ranked Sweden, skilled personnel are present at nearly all births, but in bottom-ranked Niger, such help is available for only 16 percent of women in labor.

"The good news," said MacCormack, "is that we know what it takes to help these moms and children survive and thrive."

The report highlights the three areas it says have the most influence on child well-being: female education, presence of a trained attendant at birth and use of family planning services.

Educated women, the report said, are more likely to marry and give birth later in life, to seek health care and to encourage education for their children, including girls.

The report said that family planning and increased contraception use leads to lower maternal and infant death rates. Many women and children in developing nations, it said, die as a result of births that come at the wrong time -- too close together, too early or too late in the mother's life.
 
This is pretty embarrasing and not all that surprising.

Ignorant people all the time talk about the great US health care system where there is no government interference, where there are no waiting lists for bypass surgeries, where you can get any surgery performed no questions asked, etc. etc.

Of course, nobody actually asks if these surgeries and procedures save lives (Despite the overwhelming disparity in number of procedures performed and number of dollars spent, heart attack victims in the US do no better than heart attack victims in Canada). Nobody asks if it is a good use of health care dollars to keep an 80 year old alive for weeks in an ICU with very little chance that person will ever live independently.

All these things could be understood if the US at least took care of the most vulnerable members of society adequately, but this report shows that it fails miserably at that as well.

But at least the US consumer is soooo much better educated than other countries, with all those ads for Nexium, Vioxx, and Zoloft. :roll1:
 
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Of course, nobody actually asks if these surgeries and procedures save lives (Despite the overwhelming disparity in number of procedures performed and number of dollars spent, heart attack victims in the US do no better than heart attack victims in Canada). Nobody asks if it is a good use of health care dollars to keep an 80 year old alive for weeks in an ICU with very little chance that person will ever live independently. :roll1:

A few people do. Former Colorado Governor Dick Lamm for one is well-known for asking those questions. Unfortunately, there aren't enough people asking them loudly enough.
 
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While I agree the premise is sad you have to ask some hard questions. How do the countries with low infant death rates compare to the ones with high death rates in other areas?

Sweden has a population of only 10 million, a very homogeneous society. While Japan has a larger population they are probably one of the most homegoneous societies in the world.

Perhaps the US has better reporting deaths than some of these other countries?
How does the US hispanic population play into this?
What about abortion and contraception?

If you read between the lines the reason the US is so poor in the area is the simple fact that so many black women have difficult pregnancies and births. They did not say what the ages of these women are but I suspect most are teens. Like any statistical analysis the root cause should be easy to determine. How do you address it is the question.

Reminds self to check on living will. Let me die in the woods without the help of today's high tech medicne, please.
 
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I'm sure if we really dive into this subject matter, its hardly as easy as it looks. Drug and alcohol abuse in this country is out of hand and that includes women who are pregnant. Crack babies and Fetal Alcohol Syndrome are a blight on our society and contrubute to this mortality rate dramatically.

You can throw blame on our health care all you want, but an insane amount of these deaths can simply be blamed on the mother's inability to sober the fuck up.
 
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When I first saw this article, I had to wonder if they were counting the US abortion rate in that statistic.

Odd that people would care about the newborn mortality rate when they don't care about the unborn mortality rate.

I guess it's ethically easier to complain about the perception that people are receiving poor service than it is to complain about people making poor choices.

Oh, and before the self-righteous come down on my head, I'm not saying one thing about what should or shouldn't be legal. There are lots of countries with legal abortion that have far, far lower rates than we do.
 
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RE: The research also found that poorer mothers with less education were at a significantly higher risk of early delivery. The study added that in general lower educational attainment was associated with higher newborn mortality.

The report highlights the three areas it says have the most influence on child well-being: female education, presence of a trained attendant at birth and use of family planning services.

Educated women, the report said, are more likely to marry and give birth later in life, to seek health care and to encourage education for their children, including girls.

The report said that family planning and increased contraception use leads to lower maternal and infant death rates.
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Could it be that we have one of the best health care systems in the world; however, some of the mothers that are giving birth are too dumb (i.e. uneducated) to take advantage of it? Needless to say we have way too many teenage girls getting pregnant, dropping out of school, becoming a single parent, and having "no clue" how to raise and/or care for a baby.
 
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Could it be that we have one of the best health care systems in the world; however, some of the mothers that are giving birth are too dumb (i.e. uneducated) to take advantage of it? Needless to say we have way too many teenage girls getting pregnant, dropping out of school, becoming a single parent, and having "no clue" how to raise and/or care for a baby.

It's a question of problem definition. We tend to take a restrictive view of "health care system" that means "medical care system." Some of those other countries send pre-natal counselors/case-workers to the homes of pregnant woman in the hope of mitigating some of the ignorance to which you refer, which to me is part of their "health care system." We only do that a little bit, and we have substantial segments of society seeking to eliminate preventative stuff like sex education or contraceptives. Having crappy or inaccessible sex ed and little pre-natal counseling is IMO a health care system failing that magnifies the impacts of the other societal failures you reference.
 
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It's a question of problem definition. We tend to take a restrictive view of "health care system" that means "medical care system." Some of those other countries send pre-natal counselors/case-workers to the homes of pregnant woman in the hope of mitigating some of the ignorance to which you refer, which to me is part of their "health care system." We only do that a little bit, and we have substantial segments of society seeking to eliminate preventative stuff like sex education or contraceptives. Having crappy or inaccessible sex ed and little pre-natal counseling is IMO a health care system failing that magnifies the impacts of the other societal failures you reference.
Sending a nurse or counselor only works if someone other than the mother knows she's pregnant.
 
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Well, our system is far from perfect, but I just don't think universal government-mandated health care would work in this country...the population is too large, and there are too many free-loaders who would be demanding every test imaginable every time they broke a nail. There are already programs to help disadvantaged people obtain things like prenatal care...if they are not working, or not properly funded, then let's fix those, rather that overhaul the entire system to try and be like Canada.
 
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Well, our system is far from perfect, but I just don't think universal government-mandated health care would work in this country...the population is too large, and there are too many free-loaders who would be demanding every test imaginable every time they broke a nail.

actually a government run system would likely cut down on the freeloaders, by denying them treatment.

the problem in this country is that preventive care sucks. The health care system doesn't care about you until you get a disease.
 
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Merely for completeness ..
The countries with better and worse newborn mortality rates

popup.mothers.charts.2.jpg


And, to show that this is not a newly recognized issue .. from the World Health Organization.

2003 data for Infant Mortality Deaths per Thousand - children under 5

Country Deaths per Thousand
Singapore 3
Sweden 3
Iceland 4
Norway 4
Czech Republic 4
Denmark 4
Italy 4
Japan 4
Monaco 4
Slovenia 4
Spain 4
Finland 5
France 5
Korea, Republic of 5
Austria 5
Belgium 5
Germany 5
Greece 5
Luxembourg 5
Netherlands 5
Portugal 5
San Marino 5
Switzerland 5
Cyprus 5
Australia 6
Canada 6
Ireland 6
Israel 6
New Zealand 6
Brunei Darussalam 6
United Kingdom 6
Malta 6
Andorra 7
Croatia 7
Malaysia 7
Poland 7
Cuba 8
Hungary 8
Slovakia 8
United Arab Emirates 8
United States 8
Kuwait 9
Estonia 9
Chile 9
Costa Rica 10
Liechtenstein 11
Lithuania 11
Montserrat 11
The former Yugoslav Republic of Macedonia 11
Latvia 12
Oman 12

For comparison - deaths per thousand children under 5 - worst case ...

Sierra Leone - 284 deaths per thousand.

Not in any way trying to make light of the report from CNN ... this country should have the best rate of infant mortality - for it has the potential to achieve the same.
But, we are calling a crisis a poorer than hoped for placement among the industrialized nations. One that still sets the Western World as a whole far in advance of the developing nations.
 
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