THE HEALTH/WEALTH GAP

American babies are still dying at a shameful rate, but the odds are improving

Good news and bad news for US public health today: Federal data shows that the country’s infant mortality rate declined again last year, to a new low of 5.82 deaths for every 1,000 live births. But that’s still one of the worst rates in the developed world.

Infant mortality is widely considered a general indicator of a country’s health. The average rate among the 34 member countries of the Organization for Economic Cooperation and Development (OECD), including the US, has been below 4.0 since 2013.

Infant mortality rates include deaths up to one year after birth. The OECD data above actually skews the US infant death rate lower than the federal government’s own estimation, because the OECD excludes the deaths of extremely premature babies, while the US does not. All the same, at the time of the OECD’s latest calculations in 2013, the adjusted US infant mortality rate of 5.0 was still dismal compared to nearly every other OECD nation.

Public health indicators such as infant mortality rates, obesity rates, and annual numbers of drug-related deaths continue to be a source of shame for the US, which spends more money on healthcare than any other nation in the world. Infant mortality, in particular, has been singled out as proof that the US healthcare system fails its poorest citizens, in ways that other nations’ do not.

“Infant mortality rates among wealthy Americans are similar to the mortality rates among wealthy Fins and Austrians,” wrote the Washington Post last year. “The difference is that in Finland and Austria, poor babies are nearly as likely to survive their first years as wealthy ones. In the US—land of opportunity—that is starkly not the case.” The Post cited a study (PDF) highlighting the impact of healthcare for newborns after they leave the hospital. It’s in those ensuing months that American babies struggle to survive.

Worldwide, the average infant mortality rate is 32 deaths per 1,000 births, according to the UN World Health Organization (WHO). Afghanistan tops the CIA World Factbook’s list of highest national infant mortality rates, where an estimated 115 out of every 1,000 babies dies within a year after birth.

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