Two weeks ago, Nicholas Kristof wrote a column on the first increase in the American infant-mortality rate in decades, taking the opportunity to excoriate Americans and the Bush administration as uncaring and unresponsive to the deaths of children. He compared the US unfavorably with Cuba and China, conveniently forgetting that the former hardly has a track record in reliability and the latter routinely kills babies as part of a forcible one-child policy.

At the time, I posted a harsh critique of Kristof's use of statistics and his overall argument. Some commenters postulated that the aggressive nature of American perinatal care created more opportunity for infants to survive just long enough to be counted as neonatal fatalities when they die just after birth. Now Steve at Secure Liberty notes that the Center for Disease Control has come to that same conclusion:

Overall, there were 27,970 infant deaths in 2002 compared with 27,568 in 2001. In 2001, there were 6.8 deaths per 1,000 live births. In 2002, there were 7.0 infant deaths per 1,000 live births.

During that same time period, the numbers of very low birthweight babies increased by almost 500 births. This increase occurred among mothers aged 20 to 34 and across most racial and ethnic groups, the report shows.

Though infant deaths had been declining for these vulnerable, small babies, the majority of babies born at this weight still die within the first year of life. ...

Technological advancements have also played a role, MacDorman notes.

The increased use of assisted reproductive therapies (search), like in-vitro fertilization (search), has been linked with an increase in multiple-birth pregnancies and low birth weight babies. Changes in labor and delivery technologies, and aggressive treatment of premature rupture of membranes, may also be boosting the numbers, MacDorman writes.

Also, advances in neonatal medicine have prompted doctors to alter their perception of a very small infant’s chances of survival. In fact, what might have been reported as a “fetal death” may now be reported as a “live birth,” writes MacDorman. “Because these very high risk infants are likely to succumb within the first few hours or days of life, any significant shift in reporting could result in an increase in the infant mortality rate.”

In other words, babies that would die in the womb or at stillbirth elsewhere are born alive in the US. Many of these survive completely, but because of their precarious state, they tend to die at higher percentages than normal births. That's why the numbers rose slightly for 2002. The CDC doesn't expect to see another increase like it.

Next time, Kristof should check his assumptions before hitting the panic button. He also might want to rethink holding China up as an example for the world in infant care while they kill thousands each year in forcible abortions and infanticide.

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» Lies, damned lies, and twisted interpretations. from Accidental Verbosity

Believe it or not, I've actually seen people argue that the US infant mortality rate is evidence of *too much* medicine, and that the reason that rates are lower in some suprising places is that because without doctors intervening in the natura...

Tracked on January 25, 2005 10:33 AM