Wednesday, May 26, 2010

The Reality of Child Mortality

Have you noticed any of the recent articles on child mortality across the world? Here in the UK the headlines have told us that we have the highest death rate of under-5s in the whole of Western Europe, with 5.3 deaths per 1000 live births. That compares with Sweden's 2.7.

But the figures from other Americanised cultures are equally as bad: Australia had 4.7 deaths per 1000, Canada had 4.9 and the US had a shocking 6.7.

Child deaths are falling across the world, in developing as well as developed nations. But I still have to wonder why they are higher in American-type cultures than European countries. The reasons are obviously very complex but increases in obesity, fertility treatment and average maternal age are surely important factors.

Could the private American health system also be to blame for it's terrible child mortality? The UK's National Health Service is far from brilliant, but at least every mother has easy access to quality obstetric and paediatric care if it is needed.

Years ago, before the NHS was established, my great great aunt lost her two year old son to diptheria because she could not afford to take him to hospital. She never had another child and for the rest of her life she cursed herself for failing to save him. This is the reality behind child mortality.


Betsy B. Honest said...

It's the most unimaginable heartbreak I can imagine. I would do ANYTHING to keep my babies alive. My heart just breaks thinking about being a mom in a different reality where I didn't have access to excellent and free health care.

Pickle said...

sick isn't it? Before I had my baby I saw the movie 'the busines of being born' you should check it out. It's about child fatality rates and is for more midwife/homebirths.
I think the reasons you mentioned, obesity, fertility treatments, etc are prob big ones in the US. Sometimes I wonder if the people actually getting health care are really getting good health care. Lots of docs just try and throw pills at problems. I don't think that birth and babies get the respect they deserve either...
I just think it's so shocking that in the US (or any other developed country) who has the resources to produce the best health care, we have worse child fatality rates. When will this be addressed?

Melodie said...

Wow! That's so scary. I'm very thankful for our health care system in Canada. Even though it's not perfect, it's much better than the US system, which still shocks me every time I hear some new atrocity.

Cave Mother said...

Pickle - undeveloped nations still have much worse infant mortality than developed ones, though they are improving. For example, the article I linked to states that:

In the African state of Equatorial Guinea, some 180 out of 1,000 children die before their fifth birthday.

Now that is shocking.

But as to why countries like the US have worse child mortality than poor "second world" countries like Cuba.. that's a difficult one.

Pickle said...

yeah oops i meant to say second developed countries. It's so sad. Poor sweet innocent children.

Lisa C said...

Some believe unnecessary intervention in childbirth can be to blame, thought that just relates to births and doesn't account for the rest of infancy. It would be interesting to know what the correlation might be. I sure would love to know what more I can do for my child to protect his health.

Lauren @ Hobo Mama said...

That story of your great great aunt is heartbreaking. Oh, sorrow.

Um, hm, why does the US suck? I've actually thought long and hard about this. I do think lack of affordable healthcare is a big part. For instance, as I am self-employed I buy my own health insurance. If I want to have maternity coverage, I have to pay 3-4x what I'm paying now monthly for insurance. If I get pregnant "accidentally," there's a waiting period before I'm covered even if I switch to the expensive plan then. A nine-month waiting period. (Not joking.) I think this is sexism and shocking and I can't believe it's been legal for so long to deny coverage so basic to half the adult population. If I get pregnant without maternity coverage and there are any complications that would suggest not using my preferred option of paying directly for midwifery care and a homebirth, I will be in the untenable position of choosing between my health/the health of my (unborn or newborn) baby and my financial solvency. "Normal" hospital births cost about $10,000. I don't even want to think about what complicated births cost. Ugh.

Secondly, as Lisa mentioned, the US is very aggressive about interventions. We don't have a midwifery model of prenatal care or childbirth, which affects our C-section rates greatly (which in turn affects mortality). My understanding is that the fertility interventions also greatly contribute to mortality problems, because fertility treatments lead to multiples lead to interventions lead to complications, etc. Premature infants are likely to have health issues even post-birth, and multiples are more likely to be premature, so it's all related.

I wonder what the breastfeeding rates are in the US vs. Europe. Do you know? Or SIDS? Because I know they're linked.

I wonder, too, about car accidents. The US is pretty cruddy about encouraging extended rear facing, which is part of what's helping Sweden along toward such good rates. I don't think the UK is all that great in that aspect, from forums I've been on, but I don't know about the rest of Europe or Canada or Australia.

Anyway, I'm just all jealous of you all and your free healthcare! Here's hoping the US is on the road to improving healthcare coverage and eventually healthcare itself. Fingers crossed.

Cave Mother said...

Lisa - Birth interventions do have an effect I think, but I'm sure it's small compared to the factors mentioned in the articles. I think you can also get hold of infant mortality figures (death of under-1s) which would give momre detail on this.

Lauren - I never knew about healthcare not covering pregnancy. That's awful. What a strange situation.
I think the US has one of the worst breastfeeding rate of the "developed" countries. The UK is probably not that much better though. Sweden and the other Scandinavian countries have much better maternity leave arrangements and consequently much higher breastfeeding rates. From what I hear, their hospitals are also a lot more enlightened about baby-friendly practices like co-sleeping and kangaroo care.

Pickle said...

I've been reading a blog called peaceful parenting
They talk a lot about circumcision and how it's unnecessary and how it could be traced back to infant moralities that were blamed on something else instead. They also have a recent post about ultra sounds being harmful.
So after thinking about this for a while, I think there is a lot of things we do that haven't been researched enough or just overlooked. I still can't believe we haven't at least attempted to cut down on this rate.