Automobiles per capita
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Differences in the reporting of live births between countries can have an impact on international comparisons of infant mortality.
In the United States and in 14 of 19 European countries, all live births at any birthweight or gestational age are required to be reported. Also, since no live births occur before 12 weeks of gestation, the requirement for Norway that all live births at 12 weeks of gestation or more be reported is substantially the same as for countries where all live births are required to be reported.
So the US does report all live births as such, while many other countries do not count all live births in certain circumstances, which does result in the US having a higher infant mortality rate than countries with different standards.
[quote]The U.S. infant mortality rate was still higher than for most European countries when births at less than 22 weeks of gestation were excluded.
When births at less than 22 weeks were excluded, the U.S. infant mortality rate dropped from 6.8 to 5.8 infant deaths per 1,000 live births in 2004 (2).[/quote
So while this does affect the statistics, it does not affect them that much. If we exclude premature births from the statistics (as other countries often do), then the infant mortality rate in the US drops significantly, but is still significantly higher than most European nations.
However, when it comes to premature infants, the US comes out better than most:
So the US has a lower mortality rate for pre-term infants (which some nations don't even count at all), but for babies born at term, the US has a significantly higher mortality rate.The infant mortality rate for infants born at 24-27 weeks of gestation was lower in the United States than in most European countries (except Norway and Sweden) seven countries had higher rates. For infants born at 28-31 weeks of gestation, the U.S. rate was lower than for all countries shown except Austria, Denmark, and Sweden. For infants born at 32-36 weeks of gestation, the U.S. infant mortality rate was lower than for all countries shown except Austria and Norway. However, for infants born at 37 weeks of gestation or more, the United States’ infant mortality rate was highest among the countries studied.
Another interesting difference, however, is the rate at which pre-term babies are born:
The US has a far higher rate of pre-term babies being born, and given the higher mortality rate of pre-term babies (in all countries), this brings the US down in infant mortality rankings.In 2004, when births at less than 22 weeks of gestation were excluded, 12.4% of U.S. births were preterm, compared with 5.5% in Ireland, 6.3% in Sweden and France, and 7.4% in England and Wales. In the United States, 1 out of every 8 births were born preterm, whereas in Ireland and Finland only 1 out of 18 births were born preterm.
So, according to the CDC, while the differences in data collection don't account for the America's poor ranking in terms of infant mortality, the differences in the rate of pre-term babies does account for it.
In 2005, the United States ranked 30th in the world in infant mortality, behind most European countries, Canada, Australia, New Zealand, Hong Kong, Singapore, Japan, and Israel. There are some differences among countries in the reporting of very small infants who may die soon after birth. However, it appears unlikely that differences in reporting are the primary explanation for the United States’ relatively low international ranking.
The primary reason for the United States’ higher infant mortality rate when compared with Europe is the United States’ much higher percentage of preterm births. In 2004, 1 in 8 infants born in the United States were born preterm, compared with 1 in 18 in Ireland and Finland. Preterm infants have much higher rates of death or disability than infants born at 37 weeks of gestation or more (2-4, 6), so the United States’ higher percentage of preterm births has a large effect on infant mortality rates. If the United States had the same gestational age distribution of births as Sweden, the U.S. infant mortality rate (excluding births at less than 22 weeks of gestation) would go from 5.8 to 3.9 infant deaths per 1,000 live births, a 33% decline.
So according t the CDC, the main problem with infant mortality in the US is pre-term birthrates themselves.
The WHO ranking isn't looking at how good the healthcare system is for a millionaire, it's looking at how good it is overall.
That's like comparing the entire education system to a select few private schools.
Think about Soviet Russia. If you were in a small town and you didn't have any connections, you might go to a shitty filthy hospital without running water. However, if you had connections in the Party and had the right job, you could get some of the best healthcare in the world.
On that subject, however, I will tell you that when I was in PPU in that last hospitalization, I had a nice glass room in a well maintained unit. When I got better, they transferred my to what I call the Prison Ward where conditions were much different... and what you might expect to see in an Eastern European country.
Anyway, I never said that healthcare was awful, I said that our patchwork system is expensive and works against those who are who would like to be self employed and in small business.
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