To explore this, the authors conduct a counterfactual exercise, as reported in the figure. The first column shows the IMR difference for singleton births after 22 weeks and above grams - 1. The next column reports what the IMR difference would be if the U.
Under this scenario, the U. By contrast, the U. The remaining two columns show what the IMR difference would be if U. Conditional on birth conditions, the neonatal mortality rate in the U. However, the post-neonatal mortality rate is much lower in Austria than the U. Applying Finland's mortality rate, the U. In short, worse conditions at birth and a higher post-neonatal mortality rate are both important contributors to the U.
Finally, the authors explore how the U. IMR disadvantage varies by racial and education group. They find that the U. When countries have different methods for reporting infant deaths, it is primarily a matter of how they report deaths among infants with very low odds of survival. According to the OECD, the United States and Canada register a higher proportion of deaths among infants weighing under g, which inflates the infant mortality rate of these countries relative to several European countries that count infant deaths as those with a minimum gestation age of 22 weeks or a birth weight threshold of g.
Without adjusting for data differences, the U. While differences in data collection likely explain some of the variance in infant mortality rates by country, this should not affect the relative rates of change over time, assuming data collection methods have not changed considerably.
From to , the infant mortality rate in the U. Over the same period of time, the comparable country average improved by 26 percent, falling from 4. Relative to comparable countries on average, the U. From to , neonatal deaths deaths less than a month after birth decreased by 15 percent in the U. Cross-national data reporting differences may explain some of the U.
Perinatal mortality rates, which reflect both early neonatal and some fetal deaths, are considered an indicator of the quality of antenatal and perinatal care. It is not clear if this variation reflects the quality of newborn care in the U. Visit the Dashboard. Dashboard Interactives Video About Us. Two thirds of infant deaths in the U. Infant mortality rates are relatively high in southern states. Mortality rates are higher than average among infants born to mothers who are Black, American Indian and Alaska Natives, and Pacific Islanders.
Neonatal mortality is highest among infants of Black mothers. Infant mortality is highest among mothers under age Congenital malformations are the most common cause of infant death in the U. The leading causes of infant death in the U. Infant mortality is higher in the U. Medicaid is the largest payer for maternity care in the U. A disproportionate number of Black and Latino women are Medicaid beneficiaries. However, many pregnant women enrolled in Medicaid experience a coverage gap during both the prenatal and postpartum periods.
Each year hundreds of thousands of mothers are kicked off Medicaid two months after giving birth. States have the option to extend postpartum Medicaid eligibility, so mothers who have given birth can stay insured for a full year after.
But, most mothers lose coverage after 6 weeks, because states fail to exercise the option of extending coverage. In April , Illinois became the first state to be approved by the Department of Health and Human Services to extend Medicaid up to a one year after a woman gives birth.
Instituting policies, such as the one being implemented in Illinois, that target-less advantaged groups, from prenatal to post-neonatal care - may be an effective way of reducing infant mortality in the U. Other potential policy levers include coverage of home nurse visiting programs and Doula care. Doula care is an underutilized resource in improving maternal and infant health.
Yet, Doula care is not paid for by most Medicaid programs. In practically all other peer nations in terms of GDP per capita, pre- and postnatal care is comprehensive and universal. This includes services like Doula care, but also home nurse visiting programs and midwifery. The Dutch, for example, have a unique obstetrical model which relies heavily on midwives, along with comparable services to Doula care.
The maternal mortality rate is almost three times lower than the U. The persistent problems with maternal and infant mortality point to a larger problem of often inadequate and fragmented public health in the U. Long before the Covid pandemic struck, there were signs of structural inefficiencies and comparatively mediocre outcomes throughout the U. In the past decade, U.
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