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Message Area
American Issues

Baby deaths

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#1 of 23

     Posted Nov-5 3:43 AM   
nyqconly
 
From  nyqconly  Posts 3001  Last Nov-21
To  All      [Msg # 213508.1 ]    
A key issue in the health care debate has been the poor performance of the US on a number of international indicators. One very notable measure is infant mortality - a measure against which the US scores badly when compared with other developed nations. However the legitmacy of that comparison is not strong - other nations count infant mortality differently making a simple comparison of figures potentially invalid.

The National Center for Health Statistics has published a study that looks in the figures in more detail. Three major findings are worth considering and reveal even more complexities:
1. even accounting for different methods for counting infant mortality the US still ranks poorly when compared to other developed nations.
2. the US compares favourably when survival rates of pre-term babies are considered.
3. the OVERALL number of pre-term babies is higher in the US and contributes significantly to the higher infant mortality rate.

The report can be found here:
http://www.cdc.gov/nchs/data/databriefs/db23.htm

New York Times article is here:
http://www.nytimes.com/2009/11/04/health/04infant.html?_r=1&hpw

March of Dimes take on the study can be read here:
http://www.marchofdimes.com/aboutus/49267_61938.asp



hi!

Yet more pleonastic ravings!

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#2 of 23

     Posted Nov-5 10:18 AM   
gordonhofer
 
From  gordonhofer  Posts 31345  Last Nov-24
To  nyqconly      [Msg # 213508.2 Message 213508.2 replying to 213508.1 213508.1 ]    
the OVERALL number of pre-term babies is higher in the US and contributes significantly to the higher infant mortality rate.

That's very interesting data. It opens an entirely different discussion about how the number of pre-term births affect the infant mortality rate. The March of Dimes report due out later this month will be important in evaluating the causes of pre-term births in various groups and what can be done to reduce them.

Thanks for the information.
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#3 of 23

     Posted Nov-5 1:15 PM   
nyqconly
 
From  nyqconly  Posts 3001  Last Nov-21
To  gordonhofer      [Msg # 213508.3 Message 213508.3 replying to 213508.2 213508.2 ]    
//That's very interesting data. It opens an entirely different discussion about how the number of pre-term births affect the infant mortality rate.//

You are right. On one side the situation is real and not just a statistical glitch and on the other it doesn't seem to be a specific problem with US hospitals or medical care.
Reality once again proves to be more interesting than rhetoric!


hi!

Yet more pleonastic ravings!

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#4 of 23

     Posted Nov-6 11:24 AM   
Silence Dogood (R-NJ)
 
From  Silence Dogood (R-NJ)  Posts 6126  Last Nov-24
To  nyqconly      [Msg # 213508.4 Message 213508.4 replying to 213508.1 213508.1 ]    

>>The National Center for Health Statistics has published a study that looks in the figures in more detail. Three major findings are worth considering and reveal even more complexities:1. even accounting for different methods for counting infant mortality the US still ranks poorly when compared to other developed nations.<<

Infant mortality is a function of the quality of the patient, not the quality of the healthcare.

"Endure, Master Wayne. Take it. They'll hate you for it, but that's the point of Batman, he can be the outcast. He can make the choice that no one else can make, the right choice." --Alfred, from The Dark Knight

 

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#5 of 23

     Posted Nov-6 11:33 AM   
plsulli41
 
From  plsulli41  Posts 1909  Last Nov-24
To  Silence Dogood (R-NJ)      [Msg # 213508.5 Message 213508.5 replying to 213508.4 213508.4 ]    

Infant mortality is a function of the quality of the patient, not the quality of the healthcare.

And the quality of the patient greatly improves with easily accessible healthcare and prenatal healthcare.

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#6 of 23

     Posted Nov-6 11:40 AM   
Silence Dogood (R-NJ)
 
From  Silence Dogood (R-NJ)  Posts 6126  Last Nov-24
To  plsulli41      [Msg # 213508.6 Message 213508.6 replying to 213508.5 213508.5 ]    

>>And the quality of the patient greatly improves with easily accessible healthcare and prenatal healthcare.<<

Have any data? I seriously doubt that infant mortality in the US is substantially caused by inaccessibility to prenatal care. The problem is a largely a function of drug abuse and addictions. That's been widely documented.

 

"Endure, Master Wayne. Take it. They'll hate you for it, but that's the point of Batman, he can be the outcast. He can make the choice that no one else can make, the right choice." --Alfred, from The Dark Knight

 

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#7 of 23

     Posted Nov-6 11:47 AM   
John Clifton (Sysop)
 
From  John Clifton (Sysop)  Posts 23916  Last Nov-24
To  Silence Dogood (R-NJ)      [Msg # 213508.7 Message 213508.7 replying to 213508.6 213508.6 ]    
<SD> The problem is a largely a function of drug abuse and addictions.

How could we have a problem of "drug abuse and addictions" so bad it even distorts infant mortality stats?


Edited Nov-6   by  John Clifton (Sysop)
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#8 of 23

     Posted Nov-6 11:52 AM   
Silence Dogood (R-NJ)
 
From  Silence Dogood (R-NJ)  Posts 6126  Last Nov-24
To  John Clifton (Sysop)      [Msg # 213508.8 Message 213508.8 replying to 213508.7 213508.7 ]    

>>How could we have a problem of "drug abuse and addictions" so bad it even distorts infant mortality stats?<<

Because drug abuse is rampant, I guess.

 

 


"Endure, Master Wayne. Take it. They'll hate you for it, but that's the point of Batman, he can be the outcast. He can make the choice that no one else can make, the right choice." --Alfred, from The Dark Knight

 

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#9 of 23

     Posted Nov-6 11:52 AM   
gordonhofer
 
From  gordonhofer  Posts 31345  Last Nov-24
To  John Clifton (Sysop)      [Msg # 213508.9 Message 213508.9 replying to 213508.7 213508.7 ]    
How could we have a problem of "drug abuse and addictions" so bad it even distorts infant mortality stats?

You might want to take another look at post #1, and some of the links. They show that infant mortality in this country is largely a function of pre-term births, and the links provide some information about who has pre-term births and why.
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#10 of 23

     Posted Nov-6 12:09 PM   
John Clifton (Sysop)
 
From  John Clifton (Sysop)  Posts 23916  Last Nov-24
To  Silence Dogood (R-NJ)      [Msg # 213508.10 Message 213508.10 replying to 213508.8 213508.8 ]    
<JC> How could we have a problem of "drug abuse and addictions" so bad it even distorts infant mortality stats?

<SD> Because drug abuse is rampant, I guess.


And why would we have rampant drug abuse? Are we doing something wrong?

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#11 of 23

     Posted Nov-6 12:15 PM   
John Clifton (Sysop)
 
From  John Clifton (Sysop)  Posts 23916  Last Nov-24
To  gordonhofer      [Msg # 213508.11 Message 213508.11 replying to 213508.9 213508.9 ]    
<gh> They show that infant mortality in this country is largely a function of pre-term births, and the links provide some information about who has pre-term births and why.

Drug problems are one of the causes. Diabetes another. Too many overweight mamas.

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#12 of 23

     Posted Nov-6 12:38 PM   
gordonhofer
 
From  gordonhofer  Posts 31345  Last Nov-24
To  John Clifton (Sysop)      [Msg # 213508.12 Message 213508.12 replying to 213508.11 213508.11 ]    
<gh> They show that infant mortality in this country is largely a function of pre-term births, and the links provide some information about who has pre-term births and why.

Drug problems are one of the causes. Diabetes another.

And smoking, and drinking, and failure to seek pre-natal care.
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#13 of 23

     Posted Nov-6 12:50 PM   
John Clifton (Sysop)
 
From  John Clifton (Sysop)  Posts 23916  Last Nov-24
To  gordonhofer      [Msg # 213508.13 Message 213508.13 replying to 213508.12 213508.12 ]    
<gh> They show that infant mortality in this country is largely a function of pre-term births, and the links provide some information about who has pre-term births and why.

<JC> Drug problems are one of the causes. Diabetes another.

<gh> And smoking, and drinking, and failure to seek pre-natal care.

For the sake of comparison, however, other countries have smokers and drinkers. We're the ones with too many fat people and problems getting mothers to seek prenatal care.

You know, some countries send nurses around to visit pregnant women. Talk about a cost effective use of medical personnel....

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#14 of 23

     Posted Nov-6 1:45 PM   
nyqconly
 
From  nyqconly  Posts 3001  Last Nov-21
To  Silence Dogood (R-NJ)      [Msg # 213508.14 Message 213508.14 replying to 213508.4 213508.4 ]    
//Infant mortality is a function of the quality of the patient, not the quality of the healthcare.//

Perhaps. The survival rates of preterms in the US is reasonable compared to other nations so hospital care itself doesn't seem to be the issue.
To what extent the overall system is a problem is harder to tell.


hi!

Yet more pleonastic ravings!

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#15 of 23

     Posted Nov-6 1:51 PM   
nyqconly
 
From  nyqconly  Posts 3001  Last Nov-21
To  Silence Dogood (R-NJ)      [Msg # 213508.15 Message 213508.15 replying to 213508.6 213508.6 ]    
//I seriously doubt that infant mortality in the US is substantially caused by inaccessibility to prenatal care.//

Well that would be the point where you provided some data to support that. Perhaps you are correct - but you'll be more convincing if you can support your claim.

//The problem is a largely a function of drug abuse and addictions. That's been widely documented. //

I don't doubt that is PART of the problem but is really LARGELY the factor? Again I don't think we know that. Even then how should a medical system respond to that. The NYT article gives some ideas:
Taking care of women’s illnesses and problems like drinking, drug use and smoking before and during pregnancy can help prevent prematurity, he said, adding that a state program in Kentucky to provide home visits by nurses to poor women during pregnancy had decreased preterm births. (2nd to last paragraph)
http://www.nytimes.com/2009/11/04/health/04infant.html?_r=2&hpw



hi!

Yet more pleonastic ravings!

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#16 of 23

     Posted Nov-6 4:04 PM   
plsulli41
 
From  plsulli41  Posts 1909  Last Nov-24
To  Silence Dogood (R-NJ)      [Msg # 213508.16 Message 213508.16 replying to 213508.6 213508.6 ]    

Have any data? I seriously doubt that infant mortality in the US is substantially caused by inaccessibility to prenatal care.

From a CBO report (http://www.cbo.gov/doc.cfm?index=6219&type=0)

Federal and state initiatives to lower infant mortality rates have focused on strategies to reduce financial barriers that limit access to prenatal care and on strategies to expand the supply of prenatal care services available to poor pregnant women. The relative advantages and disadvantages of these and other policies to reduce low birthweight and infant mortality are the focus of considerable debate. Recent expansions of the Medicaid program are enabling more low-income children and pregnant women to obtain the health care that they need. Being eligible for Medicaid does not necessarily guarantee access to care, however, especially in areas where providers are in short supply. Hence, federal programs that provide direct support for maternal and child health services and primary care for low-income populations are also important. Some policy researchers believe, moreover, that the scope of strategies to reduce infant mortality should be broadened from a relatively narrow focus on pregnancy care to the more general issue of how to improve the health status of poor women and their families.

The CDC also concludes that the primary cause for infant mortality is low birth weights:

http://www.hhs.gov/asl/testify/t970313a.html

 The problem is a largely a function of drug abuse and addictions. That's been widely documented.

Have any data?

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#17 of 23

     Posted Nov-7 9:51 AM   
gordonhofer
 
From  gordonhofer  Posts 31345  Last Nov-24
To  nyqconly      [Msg # 213508.17 Message 213508.17 replying to 213508.15 213508.15 ]    
<sd> //I seriously doubt that infant mortality in the US is substantially caused by inaccessibility to prenatal care.//

<nc> Well that would be the point where you provided some data to support that. Perhaps you are correct - but you'll be more convincing if you can support your claim.

I think it's caused less by inaccessibility than by a failure to use what is available. Looking at the cites you provided, we see what groups are more likely to have pre-term deliveries. While we'll still need that March of Dimes report to get more specific data, it doesn't appear to be an economic problem. IOW, there are some groups that are generally lower on the economic scale but, within the low economic groups there are those who have more or fewer pre-term deliveries. Some poor and/or minority groups have more such deliveries than other poor groups. Why is that, I wonder?

Is it perhaps a clue to our standing vis a vis other countries that are smaller and more homogenous?
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#18 of 23

     Posted Nov-7 9:56 AM   
gordonhofer
 
From  gordonhofer  Posts 31345  Last Nov-24
To  plsulli41      [Msg # 213508.18 Message 213508.18 replying to 213508.16 213508.16 ]    
Being eligible for Medicaid does not necessarily guarantee access to care, however, especially in areas where providers are in short supply. Hence, federal programs that provide direct support for maternal and child health services and primary care for low-income populations are also important.

Perhaps one approach would be to increase Medicaid reimbursement, at least specifically for pre-natal care. Providers in some areas are in short supply because the reimbursement to providers is so low. It would also seem that some protection against very large lawsuits from pre-natal and delivery conditions would encourage these low-paid providers to expand their practice.
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#19 of 23

     Posted Nov-7 12:08 PM   
John Clifton (Sysop)
 
From  John Clifton (Sysop)  Posts 23916  Last Nov-24
To  gordonhofer      [Msg # 213508.19 Message 213508.19 replying to 213508.18 213508.18 ]    
<gh> Perhaps one approach would be to increase Medicaid reimbursement, at least specifically for pre-natal care.

I have an idea... how about decent health care for every American?

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#20 of 23

     Posted Nov-7 1:40 PM   
gordonhofer
 
From  gordonhofer  Posts 31345  Last Nov-24
To  John Clifton (Sysop)      [Msg # 213508.20 Message 213508.20 replying to 213508.19 213508.19 ]    
<gh> Perhaps one approach would be to increase Medicaid reimbursement, at least specifically for pre-natal care.

I have an idea... how about decent health care for every American?

Just how would that encourage groups of people to seek pre-natal care who don't now seek it?
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American Issues

Baby deaths

  
 
     
 
 

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