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Why is the U.S. Infant Mortality Rate So High?

baby's feet in father's handStory Highlights
  • Despite spending more per capita of any country, the U.S. has one of the worst rates of infant mortality of all developed countries.
  • The U.S. has a high rate of pre-term births and socioeconomic factors also play an important role.
  • Sudden Unexpected Infant Death (SUID) significantly affects the rates of infant mortality in the U.S.

Infant mortality, defined as death within the first year of life,1 is commonly accepted as one of the key gauges of a nation’s socioeconomic development. So how is it possible that the United States, which spends more on health care per capita—$8,713 per person annually2—than any country, has one of the highest levels of infant mortality among the world’s developed countries? According to the U.S. Central Intelligence Agency, “This rate is often used as an indicator of the level of health in a country.”

In 2015, the CIA ranked the U.S. 167th out of 224 countries monitored for number of infant deaths per 1,000 live births, which measures a country’s infant mortality rate, or IMR.3 Afghanistan (#1) came in with the highest IMR, at 115.08 deaths per 1,000 live births, and Monaco had the lowest IMR at 1.82. The U.S. IMR of 5.87—sandwiched in between Slovakia (6.05) and Croatia (5.77)— has been called “a national embarrassment.”4 

Data from a 2011 World Bank report placed the U.S. 46th in infant mortality worldwide and showed that “every year twice the number of U.S. babies die on their first day alive than in all 27 European Union nations combined, although 1 million more are born there (4.3 million versus 5.3 million respectively).”5 

Comparing infant mortality only among developed nations, a report from the National Center for Health Statistics placed the U.S. in 27th place among “Organization for Economic Co-operation and Development” countries.6 What are the reasons for these puzzling infant mortality rates in one of the wealthiest countries in the world, and what is being done to address the situation?

The Percentage of Preterm Births Continues to Increase

Historically, infant mortality rates declined dramatically during the first half of the 20th century as sanitation, access to health care and technology improved. The addition of neonatal intensive care units to hospitals and the recognition that folate supplements could prevent many miscarriages and birth defects were only two of the developments that improved infant mortality, but the gap between the U.S. and other developed nations has persisted.4 

The high infant mortality in the U.S. has many contributing factors that, taken together, may provide some clarity to the statistics. One of the most widely repeated causes of these high infant mortality rates, commonly cited by health authorities such as the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), is that the U.S. is experiencing  an increase in the percentage of infants born very prematurely (before 28 to 32 weeks gestation) without a corresponding decrease in the percentage of those tiny infants whom are able to be saved.

According to the CDC, “very preterm infants accounted for only 2% of births, but over one-half of all infant deaths in both 2000 and 2005. Because the majority of infant deaths occur to very preterm infants, changes in either the percentage of these infants or in their infant mortality rate can have a large impact on the overall infant mortality rate.”7 This relates both to preterm infants who die soon after birth and those who die later from complications related to their preterm status.

Incompatible Definitions of Live Births Influence Reported Rates

Another influential factor is differences in reporting methods. The U.S. identifies any infant who is alive at birth as a “live birth.” Considering that the chances of survival for an infant born at less than 23 weeks’ gestation are slim,8 many other countries classify a child born at less than 22 weeks’ gestation as a miscarriage or stillbirth and so do not consider their numbers in establishing infant mortality rates.

However, even “[a]fter excluding births at less than 24 weeks of gestation to ensure international comparability, the U.S. infant mortality rate was 4.2, still higher than for most European countries and about twice the rates for Finland, Sweden, and Denmark.”6 

Impact of Socioeconomic Factors

Looking only at neonatal mortality (defined as the period from birth through 28 days), U.S. rates compare similarly to other developed nations. It is in the postnatal period (over 28 days to under a year), that the discrepancies become stark.

Many of the standard socioeconomic factors come into play in the postnatal period, when infant mortality rates show a significant correlation with lack of prenatal care and lower education and income levels of birth mothers, as well as maternal age (both teens and those over age 40), and whether the mother is married or a single parent.9 There are also strong differences between geographical areas, with Alabama, Mississippi, and Louisiana having the highest rates of infant mortality and Massachusetts, Vermont, and Iowa having the lowest.10 

Christopher Ingraham said in The Washington Post, “If Alabama were a country, its rate of 8.7 infant deaths per 1,000 would place it slightly behind Lebanon in the world rankings. Mississippi, with its 9.6 deaths, would be somewhere between Botswana and Bahrain.”4 According to a 2015 report from the Massachusetts Institute of Technology (MIT) in Cambridge, MA, “the post-neonatal mortality disadvantage is driven by poor birth outcomes among lower socioeconomic status individuals.”11 

Even accepting that fact that improvements in prenatal care and higher education and better access to medical care and social services would improve infant survival rates in the U.S. during postnatal period, these factors still do not explain the discrepancy between the rates of infant mortality in the US compared to other developed nations.

Sudden Unexplained Infant Deaths Impact Mortality Rates

Sudden Unexpected Infant Death (SUID)—an umbrella term used to describe the deaths of approximately 3,500 infants who die every year in the U.S. with no clear cause of death. SUID is a significant contributor to the IMR in this country and these mysterious deaths continue to confound medical researchers, though there are many factors thought to contribute to SUID, from differences in sleeping positions and feeding (breastfeeding vs. formula), exposure to cigarette smoke or other drugs and timing of vaccinations have all been implicated.12 13

In 2014, there were more than 23,000 infants born alive in the U.S. who were reported to have died within one year of birth.14 If the U.S. could reduce both preterm births and infant mortality associated with full-term births to Sweden’s levels, nearly 7,300 infant deaths would be prevented every year.6


References:

1 Infant mortality. Wikipedia.
2 Stebbins S, Frohlich TC. Countries spending the most on health care. USA Today Nov. 14, 2015.
3 Central Intelligence Agency. Country Comparison: Infant Mortality Rate. World Fact Book 2015.
4 
Ingraham C. Our Infant Mortality Rate Is a National Embarrassment. The Washington Post Sept. 29, 2014.
5 
Williams S. Gone Too Soon: What’s Behind The High U.S. Infant Mortality Rate? Stanford Medicine Fall 2013.
6 
CDC, MacDorman MF et al. International Comparisons of Infant Mortality and Related Factors: United States and Europe, 2010. National Vital Statistics Reports, Centers for Disease Control and Prevention. Sept. 24, 2014.
7 
CDC, MacDorman MF, Mathews TJ. Recent Trends in Infant Mortality in the United States. National Center for Health Statistics October 2008.
8 
Romm C. Why American Babies Die. The Atlantic. Oct. 1, 2014.
9 
Scott J. Trends in Infant Mortality in United States: A Brief Study of the Southeastern States from 2005–2009. Int J Environ Res Public Health May 2015.
10 
Fox M. U.S. Infant Mortality Rate Stays High, Report Finds. NBC News Aug. 6, 2015.
11 
Chen A et al. Why is infant mortality higher in the US than in Europe? Aug. 12, 2015.
12 
American Academy of Pediatrics Policy Statement. SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment. Pediatrics November 2011.
13 
Miller NZ, Goldman GS. Infant mortality rates regressed against number of vaccine doses routinely given: Is there a biochemical or synergistic toxicity? Hum Exp Toxicol September 2011.
14 
CDC. Reproductive Health/Infant Mortality. CDC.gov.

17 Responses to Why is the U.S. Infant Mortality Rate So High?

  1. Prof. Fred Nazar Reply

    October 22, 2016 at 9:32 pm

    Prior abortion increases dramatically the risk of preterm births. The US has one of the highest abortion rates in the World after China, Russia, etc.

  2. Bill Reply

    June 2, 2016 at 3:32 pm

    I couldn’t resist commenting. Very well written!

  3. Jenpea Reply

    June 1, 2016 at 9:24 am

    How about this 2015 study proving that things do cross the Blood Brain Barrier and effect immunity. Why has no one publicly attacked vaccines now from this angle? I mean honest people in the know.
    I know both Dr Mercola & Suzanne Humphries latest video has mentioned it.

    Also, it should be known that babies kidneys are not mature enough to process out the 100% of aluminum absorbed from vaccines.

    Right…it doesn’t take a lot to put it together.

  4. michael filosa Reply

    May 13, 2016 at 3:17 pm

    You say that the US is ranked 167 out of 224 but fail to say that the ranking is in reverse order , that is: the worst country Afghanistan is ranked number 1 while the best country Monaco is ranked 224. Thus, if you were to rank the best country , Monaco, as number 1, then the US would be about number 57. Still, the comparisons you make relative to other counties would still be valid

  5. tom hidsen Reply

    May 11, 2016 at 3:13 am

    I think we may be reaching that critical point, however, when enough parents have had “the experience” and will not be silent any more. There is hope.

  6. tom hidsen Reply

    May 11, 2016 at 3:11 am

    I became informed about vaccines’ dangers about 18 years ago. So I did my own little study. I began asking parents of autistic children, or others with severe auto-immune issues, whom I would meet upon occasion, when did this occur? Usually, 2-4 years of age; the age they normally vaccinated back then. I asked maybe 25 different parents over a period of 10 years. I asked specifically if the onset followed vaccinations, and in every case except one, there was a pregnant pause, and the answer was yes. The one who said no was very defensive, however. I can say that except for that one denial, every parent said their child was perfecty normal prior to that vaccination episode. I am convinced through my own “study” and reading that vaccines are responsible for virtually all autsim cases and the other tiny amount are due to other evironmental exposure, such as heavy metals or chemicals. I still continue my “study” and I hve no doubt the answers will continue to be that same.
    I have been extremely aggrieved at what some people are willing to do for money, to destroy the lives of these precious children. I’ve tried to inform with not too much success. People have been brainwashed by the establishment. I have come to the conclusion over the years that this will not change until enough children and parents go through this terrible road to autism or premature death. Many can never be reprogrammmed until they experience it themselves. What is mind-blowing is that some parents go through it; have one or more children turn autistic before their eyes, and STILL believe vaccinations are the right thing to do and they continue to vaccinate their other children. ?????

    • Rebecca S. Reply

      January 16, 2017 at 5:44 pm

      Your “little study” is irrelevant and biased. I have a severely Autistic child–he’s aged 7.5 years and was diagnosed with “Classic Autism” on the DSM IV prior to the DSM V merging all forms of Autism into “ASD” (which is, IMO, not fair due to the extreme differences betwen PDD-NOS, Asperger’s, and Classic Autism). I have 2 children, the other being age 21 years, now. I allowed all scheduled vaccinations for my eldest, but I chose to become a selective and delayed vaxxer when pregnant with my son. I refused the Hep B at birth as well as the eye drops. I spread everything out and waited for development markers. My son’s Vaccinations did not cause my son’s Autism, heredity did.

      I was asking doctors and professionals with Autism experience to look at my son and tell me if he might be on the spectrum when he was 15 months old and they all told me it was impossible because he made eye contact. There was a specific moment when he was 18 months old when I KNEW “my son is Autistic”; it was the worst feeling in the world… maybe I wouldn’t have been so upset if I had known more FACTS about Autism rather than propaganda spread by hate groups like Autism Speaks.

      In hindsight, both myself and my son’s father remember vividly the moment when we SHOULD have realized our child was Autistic, and it happened when he opened a gift on his 1st birthday. It was a little toddler-sized rocking pony. My son became fixated on this toy, and once he was on it, he never got off again until it literally broke under him after almost a year of rocking on it from morning til bedtime every single day, crying whenever he was lifted off his pony for meals, then refusing food. He hummed while rocking. Hummed without pause for hours upon hours. By age 2, my son was not talking, but somehow, he had managed to learn to READ. He was able to read better than my college English students before he was 2.5 years, yet he did not learn to TALK until he was 6 years.

      When my son was evaluated for Autism at 5.5 on his first day of Kindergarten, the psychologist noticed something I had never noticed… my husband is Autistic, too. I thought she was insane! He’s just quiet… introverted. How could he be Autistic? How could I not notice? Crazy talk, right? NO. Turns out my husband has PDD-NOS, and this is known for having a late onset in life. Much as the average “classic” case tends to manifest around 18 months and Asperger’s may not show until later, sometimes going unchecked until Kindergarten, PDD-NOS can go completely off the radar for many people until adulthood.

      The sudden rise in Autism statistics people have linked to vaccinations is a crock. There was no “rise” there was a change in the DSM, much like the most recent change that merged 3 distinctly different developmental disorders into 1. Before PDD-NOS and Asperger’s were merged into the range of “Autism Spectrum Disorders” they existed, but they were never factored into the statistics for Autism. There are a few unfortunate coincidences at play, here: 1st Classic Autism (and oftentimes the other ASD diagnoses) tends to present around the same age the vaccines are scheduled. Children who developed Autism before vaccinations existed were not showing the symptoms until this age range; the days in which the other developmental disorders were labeled “Autism” coincided with the advent of the MMR shot. Due to the poor coincidental timing of the mutually exclusive events, people saw a disproportionate rise in Autism statistic that appeared to be related to the introduction of the MMR vaccine. Nothing actually changed—Asperger’s and PDD-NOS already existed—they simply had never been factored into the overall Autism statistics, before.

      I can imagine looking back on my son’s development and not noticing the changes until he were aged 2-2.5 years at the earliest if not for that rocking pony. We would not have had reason to ask anyone if he might need an evaluation at 15 months if not for that rocking pony. We would have never looked back at our family photos and videos and into our memories about when this started if not for that PONY. In every scenario imaginable, the rocking pony is what made the Autism painfully obvious, and once we had a proper evaluation, had educated ourselves substantially, and had really taken a cold, hard look at our son’s development, we knew the first red flag was on his 1st birthday at the moment he met his little rocking pony. If not for that toy, perhaps I would have said the same as your friends you gave the impromptu interview with leading questions but I wouldn’t have been correct, I would have simply been oblivious to the earliest signs.

      Turns out my husband’s entire paternal side has shown evidence of ASD symptoms, including his grandfather who was never vaccinated. Vaccinations do not cause Autism, it is genetic. Autism is not the end of the world, it is the beginning of a new one. Autistic people are artists, inventors, and teachers. The excel in areas neurotypical are weak in while they lack the same social skills ranging from conversational language to basic empathy which most neurotypical people take for granted. My son may be socially awkward, but he’s an amazing little human and a blessing to this world. My husband may be anti-social, but he’s also quite brilliant and logical. People on the spectrum are NOT missing a piece to their puzzle, they are whole, complete, and necessary. Their brains are hardwired differently, not incorrectly. I once lost a child when I miscarried because I was exposed to Rubella while pregnant. THAT is dangerous. THAT killed my baby. There is nothing scary about Autism except the propaganda spread maliciously, and the totally irrational fears that lead so many children to go unvaxxed to the point which babies are dying due to exposure to Rubella, Measles, Whooping Cough, etc. I am one of the 3% of the population who cannot hold an immunity to Rubella; I have had the disease once, and I have been vaccinated a total of 8 times, yet I am still not immune. Falling ill to Rubella again or losing another baby to the exposure is so much scarier than Autism, and you would know that if you had ever lived with a truly Autistic child.

      • Dani Reply

        March 9, 2017 at 1:59 pm

        This comment is bizarre and scattered…and I don’t understand its point as a response in relation to the comment that was posted. Since you are so positive that autism is in no way related to receiving vaccines, why not provide some proof? Your statements are just as anecdotal as the commenters. It is purely your opinion that autism is genetic. You might want to look into the field of epigenetics; perhaps it would swing you back to the realization that vaccines and the neurotoxins that they contain could in fact catalyze autism and other health issues. Our gene expression is a direct result of what we put into our bodies and what we are exposed to in our environments. I’d say a protein/mercury/aluminum cocktail being injected into someone-regardless if it was spaced out or on a reduced schedule etc etc- would qualify as a major epigenetic event. You also take issue with MMR being linked to autism. Perhaps you could argue that one with Dr William Thompson. He seems to believe strongly enough to put his entire career with the CDC on the line. Lastly, it’s fascinating that you still believe in “the power of vaccines” and you are someone who cannot develop immunity after vaccination!

  7. owldog Reply

    May 10, 2016 at 1:57 pm

    With AMA lobbying to use the Medicare Doctor Training program to cut back on doctor training, since 1991, and the cut backs beginning in 2001, they have met the goal of increasing doctor incomes. However, doctors now only have time to write prescriptions, order tests, order procedures, and get their education from Big Pharma and the device makers, with little time to do their own research or indulge into individual patient concerns. This may be the longest tragic episode in the history of American allopathic medicine.

  8. Jeanne Reply

    May 10, 2016 at 10:46 am

    Mark,
    You took the words right out of my mouth…! People STOP believing All gov’t agencies that say – They don’t know- err!!! ?CDC, FDA, USDA!!! They do know because they are the ones killing our children and us, Or don’t want us to get healthy! ..check out you tube: WAR ON HEALTH -FDA’s Cult on Tyranny.- An Eye opener! All Big Pharma… A $$$$ maker!!

  9. Richard Hutchinson Reply

    May 10, 2016 at 10:34 am

    It is all because of what the mother puts in stomach and
    those TOXIC vaccinations… So what will they do about
    it, NOTHING !!!

  10. James Little Reply

    May 10, 2016 at 6:39 am

    One often hears that SIDS spikes at 2, 4, and 6 months, then again at 1 year. Doctors dismiss a relationship between infant deaths and the shots that babies get at precisely this time. It’s only a coincidence, they say. However, if you talk to the parents who lost their baby, the death invariably occurred after the well-baby visit in which shots were administered. There do not seem to be any babies who die before their parents had the chance to take them to their checkups at 2, 4, and 6 months and 1 year. Has anyone studied this? My son suddenly became autistic right after his 18-month visit, not right before.

    • Mark Reply

      May 10, 2016 at 7:05 am

      Yes, in 1993 Vera Scheibner wrote the best book on the subject, “Vaccination: 100 Years of Orthodox Research shows that Vaccines Represent a Medical Assault on the Immune System”. Her book documents when vaccines were given and the sequential events of death and severe neurological damage following at very specific intervals. It was her ground-breaking book that has led to many others to do more research. YouTube has Dr. Suzanne Humphries’ videos on vaccines. She has done exhaustive research proving what most parents know intuitively.
      As a health care provider I can say emphatically, EVERY parent with an autistic or cerebral palsy child I have worked with told me their child was healthy and normal before being vaccinated and after the vaccines were given, spiraled into the damaged child they now have. My rage knows no bounds about this. That politicians passed a law for no vaccine manufacturers to be held liable is treasonous. They should be hung as the remedy in the Constitution states.

    • Shannon Reply

      May 11, 2016 at 8:21 pm

      Same here. Our son was fine until age 2 1/2! We know what caused his issues

  11. Mark Reply

    May 10, 2016 at 6:26 am

    Duh…………it doesn’t take a rocket scientist nor a medical researcher to figure out why this is so. Anyone with half a brain could know (if they stopped being so naive believing the media, doctors and drug companies)it is the combination of polluted water, radioactive pollution, pesticide, GMO laden food, heavy metal and other chemical exposure and

    ………………….wait for it……………..

    VACCINES, assaulting a literally defenseless immature immune system.

    How stupid do you have to be NOT to realize this? I mean really? The US is all of the above, and more than any other country it has the audacity to produce garbage articles keeping the “mystery” alive – “Oh we do not know why there is so much autism or deaths in this country. All these dead fish and animals washing up on the shores of WA down to CA – we don’t know why.” ARE YOU KIDDING ME? When are the people going to WAKE UP!!!!????

    • Jessica Reply

      May 10, 2016 at 12:45 pm

      I couldn’t have said it better! Thanks Mark!

    • Donna Marquart Reply

      May 10, 2016 at 1:35 pm

      I can’t agree with you more. Hanging would be too good for them. How about injecting them with those 10,000 shots that Paul Offit/Profit suggested.
      I too have such rage about the whole thing – and am not afraid to mince words with so called health providers.

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