Premature births and deaths of babies before their first birthday have driven up the United States’ infant mortality rate, which now surpasses that of 25 European and developed nations, according to a newly released U.S. government report.
The report, compiled by the Centers for Disease Control and Prevention (CDC)’s National Center for Health Statistics, preceded the World Bank’s announcement about a global healthcare fund that hopes to tackle maternal health issues in developing countries.
“I think we’ve known for a long time that the U.S. has a higher preterm birth rate, but this higher infant mortality rate for full-term, big babies who should have really good survival prospects is not what we expected,” Marian MacDorman, lead author and a senior statistician and researcher in the CDC’s National Center for Health Statistics, told MedicineNet.com.
The CDC says that one out of eight mothers across the country deliver prematurely every year. Experts say that preterm births, described as the delivery of infants more than three weeks earlier than their expected due date, results in the majority of infant deaths. Babies that survive premature births face a higher risk of respiratory problems, cerebral palsy, and hearing loss later in life.
While the United States’ health care system surpasses that of most developing countries, the infant mortality rate stands at six deaths for every 1,000 births; rates that eclipse that of Finland, Japan, Portugal, Sweden, the Czech Republic, and Norway. National maternal death rates in the U.S. — along with that of seven other countries — have also increased within a decade, despite significant spending on maternal healthcare services.
A closer look at national statistics reveals racial and social disparities in healthcare that negatively impact women of color, particularly those in African American and Native American communities. The rate of maternal deaths among African American women triples that of their white counterparts. In recent years, research has shown linkages between the poor health of newborns and unresolved chronic health issues — including heart disease, stroke, depression, diabetes, and smoking.
A recent U.S. government study also showed that hospitals in communities of color fall short in encouraging breastfeeding to women in their maternity clinics. Up to a year of nursing after childbirth ensures that babies gain long-term health benefits and stave off a host of illnesses — including juvenile diabetes, sclerosis, heart disease, and cancer, ailments that affect people of color disproportionately.
Dr. Deborah Campbell, director of neonatology at Children’s Hospital at Montefiore Medical Center in New York City told MedicineNet.com that these disparities in prenatal care often set families back for at least four generations.
“The U.S. lags behind other developed countries because there remain significant gaps in access to and utilization of prenatal and preconception care,” said Campbell. “There is a well-delineated history of racial and ethnic disparities in maternal and infant outcomes in the U.S., with black women and their infants being at greatest risk and having the highest rates of poor outcomes.”
Some mothers of color could find a solution in the maternity and preventative care services available to them under the Affordable Care Act. Before the passage of what’s known as Obamacare, less than five percent of insurance carriers included maternal health services. Now women can receive prenatal care — which includes checkups and prenatal testing — without incurring any out-of-pocket costs.
While there’s cause for celebration, some public health experts like Elizabeth Dawes Gay say that Obamacare may not go far enough in relieving the stress of life as a black woman in the United States.
In a 2013 piece published at RH Reality Check, Gay suggests that effectively addressing maternal health disparities among women of color requires addressing less conspicuous causes of social and economic inequality that perpetuate structural inequality. These factors, designated as “social detriments” by the World Health Organization, include “conditions in which people are born, grow, live, work and age.”
“Insurance coverage of health-care services is only a small part of a larger and more complex equation that…includes the built environment, community context, economic stability, and education,” Gay wrote. “[D]isparities in adverse outcomes such as low infant birth weight have increased, and disparities in maternal death remain the same, despite advances in medical technology and an improved health-care infrastructure.”
