Abstract
To reduce the rates of infant mortality in the United States, a whole set of medical and socioeconomic factors needs to be reviewed and addressed. These primarily include family income, medical insurance coverage, and the access to quality medical care. Taking into account that ethnic and racial minorities are particularly vulnerable to various infant mortality risks, national programs should primarily target these population groups. Whether the U.S. is able to address infant mortality risks will depend on the country’s ability to make medical services available to poor pregnant women, and to monitor children’s development and progress during the post-neonatal period.
Infant Mortality
Introduction: an overview
Infant mortality is one of the major health and social problems in the United States. With almost seven child deaths per 1,000 live births, the U.S. is currently ranked the 29th among other countries worldwide (U.S. News, 2008). Although infant mortality rates in the U.S. gradually decline, they are still more than 50% higher than the national infant rate goal of 4.5 per 1,000 births (U.S. News, 2008). High rates of infant mortality have long-term implications for patients (through the lack of care and insurance coverage), the quality of health care (through the deteriorating prenatal and neonatal care) and health care costs, and leave much room for improving the current infant mortality situation.
Infant mortality: implications for patients
High rates of infant mortality in the United States have a distinct ethnic and racial coloring: “black babies are still nearly 2.5 times more likely than white babies to die before reaching their first birthday” (Saenz, 2007); women with racial and ethnic background are more likely to give birth to low-weight children. The problem is that mother’s age, nutrition, socioeconomic status and access to healthcare determine her chances to give birth to a healthy child. Patients who do not have access to quality health care usually contribute into worrisome infant mortality trends. Ethnic and racial background is the central element determining one’s access to jobs, social services, and prenatal care; as a result, women from small racial and ethnic groups have more high-risk pregnancies (Saenz, 2007). That is why all infant mortality initiatives should be reviewed through the prism of various patients’ access to healthcare, taking into account social and medical disparities that are currently observed across various patient groups.
Infant mortality: health care costs
In terms of health care costs, infant mortality forms a kind of a vicious circle, where the growing costs of health care decrease public access to health care and cause higher infant mortality rates across limited ethnic groups, pushing families into highly unregulated private healthcare markets and making them seek public assistance, which consequentially makes the state compensate these public expenses by raising healthcare costs. As the state is fighting with unchangeably high infant mortality rates, “pre-person health care expenditures in the United States have risen 6.5 percent per year since 2000, and 5.5 percent per year on average since 1994” (Furnas, 2009). Simultaneously, health care costs scare off the whole population groups and make them seek medical assistance beyond the limits of traditional insurance coverage. More and more prenatal and neonatal deliveries take place in smaller community hospitals; more and more low-income pregnant women are moved away from public hospitals due to their inability to compensate for the growing costs of prenatal and neonatal care (Shi et al, 2004). As a result, infant mortality and health care costs form a threatening relationship, turning newborn children the innocent victims of misbalanced approaches to health care in the United States.
Infant mortality: the quality of medical care
Recent researches confirm the negative association between the quality of primary care, infant mortality, and the rates of low-weight births. “In multivariate models, an increase of one primary care doctor per 10,000 population was associated, on average, with a 2.5% reduction in infant mortality and a 3.2% reduction in LBW” (Shi et al, 2004). The quality of health care is one of the stumbling blocks on the U.S. way to lower infant mortality rates; constant infant mortality rates imply that the United States is not able to deliver high quality maternal health care and provide mothers with better post-neonatal conditions, including treatment of neonatal infections, reduction of injuries and better household safety (Shi et al, 2004). That is why, infant mortality rates can be used as the criteria for judging the quality of prenatal, neonatal, and post-neonatal care provided by medical institutions in the U.S.
What can be done to reduce infant mortality rates in the U.S.?
To reduce the rates of infant mortality in the United States, a whole set of medical and socioeconomic factors needs to be reviewed and addressed. These primarily include family income, medical insurance coverage, and public access to quality medical care. Taking into account that ethnic and racial minorities are particularly vulnerable to various infant mortality risks, national programs should primarily target these population groups. Whether the U.S. is able to address infant mortality risks will depend on the country’s ability to make medical services available to poor pregnant women, and to monitor children’s development and progress during the post-neonatal period. “Marked differences in infant mortality also exist by education and family income” (Singh & Yu, 1995); that is why socioeconomic family issues should form the basis for the development and implementation of all infant mortality programs at state and national levels. Until the U.S. is able to minimize the infant mortality disparities across different ethnic groups, there will still be much room for improving the infant mortality situation in the country.
References
Furnas, B. (2009). American health care since 1994: the unacceptable status quo. The Center
for American Progress. Retrieved January 15, 2009 from http://www.americanprogress.org/issues/2009/01/health_since_1994.html
Saenz, R. (2007). The growing color divide in U.S. infant mortality. Population Reference
Bureau. Retrieved January 15, 2009 from http://houstonhs.scsk12.org/~robinsonm/Mr._Robinsons_Web_Site_at_Houston_High_School/Contemporary_Issues_Resource_Page_files/The%20Growing%20Color%20Divide%20in%20U.S.%20Infant%20Mortality.pdf
Shi, L., Macinko, J., Starfield, B., Xu, J. & Regan, J. (2004). Primary care, infant mortality,
and low birth weight in the states of the USA. Journal of Epidemiology and Community Health, 58: 374-380.
Singh, G.K. & Yu, S.M. (1995). Infant mortality in the United States: trends, differentials,
and projections, 1950 through 2010. American Journal of Public Health, 85 (7): 957-964.
U.S. News. (2008). U.S. ranks 29th in infant mortality. U.S. News. Retrieved January 15, 2009
from http://health.usnews.com/articles/health/healthday/2008/10/15/us-ranks-29th-in-infant-mortality.html
