Not to diminsh the accomplishment of other countries
on low infant mortality or the very real problem we
have here......but let me tell you how statistics can
be skewed to make the US infant mortality look bad:
The United States easily has the most intensive system
of emergency intervention to keep low birth weight and
premature infants alive in the world.
The US is only one of a handful countries that keeps
detailed statistics on early fetal mortality -- the
survival rate of infants who are born as early as the
20th week of gestation.
Thus, in the United States if an infant is born
weighing only 400 grams and not breathing, a doctor
will likely spend lot of time and money trying to
revive that infant. If the infant does not survive --
and the mortality rate for such infants is in excess
of 50 percent -- that sequence of events will be
recorded as a live birth and then a death. In many
countries (including many European countries) such
severe medical intervention would not be attempted
this would recorded as a fetal death rather than a
live birth.
(the above paraphrased from a medical forum.)
That unfortunate infant would never show up in infant
mortality statistics!!!
Take Cuba (which has a better infant mortality).....
they do not register births under 1000g. The World Health Organization itself
recommends that for official record keeping purposes,
only live births of greater than 1,000g should be
included. But guess what, we do! ( and most of them
will die!)
The result is that the statistics make it appear as if
Cuba's infant mortality rate is significantly better
than the United States', but in fact what is really
being measured in this difference is that the United
States takes far more serious (and expensive)
interventions among extremely low birth weight and
extremely premature infants than Cuba (or much of the
rest of the world for that matter) does.
I am not saying the above confounding factors are the only culprits, I do believe a real dichotomy exists among the classes in this country in terms of health care access which also accounts for the differences.