When Is a Dead Baby Not a Dead Baby? (When It’s Born Outside the United States)

Save The Children has released a report on infant mortality that, among other things, claims the United States has the second highest infant mortality rate among industrialized countries. The problem with this claim, however, is that the United States and other countries can’t quite agree on what counts as a dead baby. As such, infant mortality rates aren’t directly comparable between the United States and other countries.

The problem lies in a fact that, as the Save The Children report notes, most infants who die in the industrialized world die because they are either a) born too early or b) have a very low birth weight (and, of course, the earlier the delivery, the lower the birth weight tends to be).

In the United States, an infant born prematurely and weighing less than 400 grams will receive intensive medical interventions to try to keep it alive. If, as is likely, such expensive interventions fail, the event will be recorded as a) a live birth and b) a death.

In much of the rest of the world — including the industrialized world — such extreme medical interventions would never be attempted. Moreover, this would not be recorded as a live birth or as a subsequent death.

The Save The Children report simply relies on World Health Organization statistics, and the WHO itself recommends that births of less than 1,000 grams not be registered as live births in official records. Most countries follow this definition, whereas the United States doesn’t.

How big of a difference does this make? According to the National Center for Health Statistics, in 2003 infants weighing less than 1,000 grams accounted for 48.7 percent of infant deaths in the United States.

Assuming that rate holds for the 2004 U.S. statistics the Save the Children report covers, that results in a >1,000g infant mortality rate of 3.5 per 1,000 births for the United States. That rate puts the United States barely behind countries like Japan, Finland, and Sweden which clock in at 3 deaths per 1,000 births. Not bad, especially given the largely mono-racial nature of those societies as compared to the United States.

Of course, why should we expect advocacy groups or the media to bother with such arcane statistics when U.S. has second worst newborn death rate in modern world, report says makes such a good headline?

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