US has the 2nd worst newborn mortality rate...

Different countries use different standards for classifying live births, infant deaths vs. fetal deaths.

THEREFORE, any study comparing them is FLAWED unless it corrects for (or at LEAST) acknowledges them.

There may be problems with our healthcare system, but infant care isn't one of them.

From your article:
The report, which analyzed data from governments, research institutions and international agencies, found higher newborn death rates among U.S. minorities and disadvantaged groups. For African-Americans, the mortality rate is nearly double that of the United States as a whole, with 9.3 deaths per 1,000 births.

Given how this HAS been an issue, the study SHOULD have at least addressed WHY. It leaves the impression that it is because they are "disadvantaged" and the implication is that healthcare is inadequate (YOU suggested that "If this isn't an indicator that our health care system is in need of reorganization then what is?")

Considering that the US has an approximately 12-13% black population (compared to 2% in UK, Canada includes African in "other" mostly Asian, Arab & African at 6% for example), the difference can be traced to this demographic difference alone.

The kneejerk reaction is to assume that the reason for high BIM rates is that they are, as the article states, "disadvantaged". Not true.

Black Infant Mortality Is a Problem Still Unsolved

Regardless of maternal age, education, income, or marital status, a black infant is more than two times as likely to die in the first year of life than his or her white counterpart. This disparity is linked to incidence rates for preterm delivery, low birth weight (LBW) neonates, and very low birth weight (VLBW) neonates.

So it's not being "disadvantaged". So is it healthcare?

Direct causes for infant mortality include preterm birth, which occurs in 11 percent of all pregnancies.4 Preterm delivery's relationship to infant mortality is paralleled in its incidence rates between blacks (18.4 percent in 1992) and whites (9.1 percent).5 Medical science has not yet found interventions that are fully effective in preventing preterm birth. Despite all the advances in maternal care, preterm birth rates have slowly increased, as shown in Figure 4. However, Goldenberg points out that most interventions designed to prevent preterm birth are not highly effective. Some interventions are effective, including treatment of urinary tract infection, cerclage, and treatment of bacterial vaginosis in high-risk women, but are not universally so and are applicable to only a small percentage of women at risk.4 {emphasis mine}

Do you think that if medical science had a solution it wouldn't be implemented here??

For decades, medical and social science have been perplexed by this discrepancy in mortality rates. Many studies have been conducted to attempt to isolate the root causes of BIM, with only mixed and sometimes confusing results. This has contributed to an overall lack of clarity on the issue, which sometimes gives rise to incorrect presumptions, or "myths." Click here to review Myths vs Facts.

Do take the time to disabuse yourself of the myths.

I would also suggest, though I don't know, that as in the CIA World Factbook, the only way to gather such data is to trust each individual country to report their own tally, and the criteria vary from country to country.

AND

That our use of high technology and extremely competent medical professionals may be skewing the results. Babies that would never have made it to term may be counted here where they would not elsewhere. Also, do they say anything about how many babies survive to their first birthday, or a week or a month?

As my "it wasn't the same study" Cuba example from 2002, the US leads in an odd category -- dying on their BIRTH day. Most of those are not counted as being born alive at all.

Grim and Rob (and apparently Save the Children) don't care to concern themselves with details. Odd how an organization named Save the Children WOULDN'T go out of its way to point out where heroic efforts are made EVERY DAY TO save them!

Evie

Strange url - http://reviews.cnet.com/html

Diana

Here's the "Myths and Facts" URL from that same NJ source:
http://www.state.nj.us/health/bibs/education/2myths.html

Well, Grim, you started this thread with a statement about newborn mortality rares in the U.S. The story said "The "Mothers' Index" in the report ranks 125 nations according to 10 gauges of well-being -- six for mothers and four for children -- including objective measures such as lifetime mortality risk for mothers and infant mortality rate and subjective measures such as the political status of women.".
It seems to me that the study uses something they invented called a Mothers' Index which they themselves defined. A study that bases its conclusions on a custom created thing like that index is not the same as one which uses as its basis the raw statistics.
I mentioned comparing mortality in premature births and you mentioned my looking them up. Grim, you made the initial claim about the quality in the U.S., so I would think that you should be the one to back up your claim with statistics, not say that I should supply them. That's the old make a claim and demand that others prove it wrong game. Let me give you a link to an example of such statistics so that you can see how statistical data looks as compared to something like a thing called a "Mothers' Index".
link:
http://pediatrics.aappublications.org/cgi/content/full/111/1/e61/T1
That's the sort of thing with which one might want to make comparisons with other countries. Now then, you do the leg work and dig out the figures from other countries, you're the one with the original point of view that started the thread.

... factors is contraception use it says a lot. Regardless of what one thinks about contraception, using it or not has no bearing on a mother's health. If anything, many forms carry risks.

Evie

and that negates the results of the whole study. Interesting viewpoint... isn't that akin to throwing the baby out with the bath water?

That is really breathtaking.

Evie drops a comment laden with innuendo ''Considering that one of those ... factors is contraception use it says a lot.'' to refute methodology of the study but neglects to elaborate on her point. What is this supposed to mean? If one thinks contraception is not important when considering the health of women then state why! Ultimately, this is nothing but pure opinion and substantiates nothing. It's effective only as appealing to emotion and then only if your conservative in viewpoint.

Rather she goes on to comment... ''Regardless of what one thinks about contraception, using it or not has no bearing on a mother's health.'' as a follow through. I think many AIDs experts may disagree with this remark when it comes to condoms and certain chemical contraceptives such as Nonoxyl-9 which has been clinically proven to discourage the AIDs virus (I am not claiming it allows for safe promiscuous sex so don't even go there). Either way, it really has little to do with the original subject of newborn infant mortality rates.

Look, if you... Ed, or Evie, or anyone want to discuss the ramifications of the study and the possible comment on the effectiveness of the US health care system... I'm all for it. But it was Evie who first discounted the article as USA bashing, and when I called her on politicizing the issue then you, Ed, tried to impose your preconceptions of my ''political agenda'' on the discussion.

I could go on but it would be a waste of breath and I have better things to do. Sit there and feel satisfied if you want. For me, I just wish you folks would think things through sometimes before you go into spasms of indignity about socially conscious subjects that threaten the conservative paradise you think we live in.

Regardless of all this and other efforts at misdirection. I am still curious about the malicious intent of the study to malign the US which was the original objection Evie had.

where the issue has been addressed in detail.

Don't mischaracterize my positions if your intent is to gain clarification. If my reasons are not apparent to you, ask.

First of all,

You have addressed NONE of my concerns about the study or if it relates to healthcare in general. So now you've resorted to mischaracterizing my positions and, in the subsequent post, attacked me for not being wordy enough in expressing my opinions.

Those are the tactics of a desparate man. One wonders why being married, or the parents being married for the newborn, was NOT in the Mother's index while use of modern contraception is (I wonder if condoms are considered "modern", and they are not technically used by the Mothers in this study). AIDS may be a significant issue in the third world, but it's not in the developed world IN THE OVERALL SCHEME OF THINGS.

Last post unless you decide to actually discuss the subject rather than critiquing the posting style of those that are trying to discuss the topic with you.

I hate to post almost 3 days later but school has kept me occupied...

''If my reasons are not apparent to you, ask.''... All I can say in response to this is that I did ask about several issues and specifically said '' I am still curious about the malicious intent of the study to malign the US which was the original objection Evie had.'' How much more clear a request for clarification can be made?... how about this... you said ''How sad ''Save the Children researchers) have a need to grossly malign a country that does more TO try to save these babies than any other.''... prove they had a need and demonstrate how they grossly maligned the US.

The fact that complaints of USA bashing and malicious intent have become acceptable substitutes for rational consideration of critical revelations is a sad statement in my opinion. The efforts made to discredit this survey are flawed and misdirected at best... and had nothing to do with the survey at all in one case. Especially trying to negate the study by it's inclusion of contraception use as a criteria in female health standards.

Evie, you made an outrageous statement and then tried to back away from it while still trying to discredit the study. You then tried to put me in a position where I had to address only your objections ie ''You have addressed NONE of my concerns about the study or if it relates to healthcare in general.''

Finally you said... ''Those are the tactics of a desparate man. One wonders why being married, or the parents being married for the newborn, was NOT in the Mother's index while use of modern contraception is (I wonder if condoms are considered ''modern'', and they are not technically used by the Mothers in this study). AIDS may be a significant issue in the third world, but it's not in the developed world IN THE OVERALL SCHEME OF THINGS.''

To answer all your concerns...

1 - I am not desperate in this discussion thank you. Trying to paint me as such speaks volumes of your position. But to be fair I did say you had painted yourself into a corner so quid pro quo there.

This study was designed to address third world issues more than the western world so I'm amazed you even ask these questions but...

2 - ''One wonders why being married, or the parents being married for the newborn, was NOT in the Mother's index'' Where is it written that marriage is a direct indicator of a women's health? Marriage in the third world is not as tangible as in the developed world, especially in Africa. Also consider the use of rape by invading ethnic groups such as the arabs in Sudan's Darfur province designed to dilute the native ethnic africans. Pregnancy in the Third World is often not the result of consensual relations! In other words, you are trying to place western values as a significant factor in parts of the world where a latrine is more important than a wedding ring. But just to humor your question...IF marriage is so important an indicator, what if you are the 2nd, 3rd or even 6th wife? How does that figure into your statistical methodology?

3 - ''(I wonder if condoms are considered ''modern'', and they are not technically used by the Mothers in this study)'' this is just glib rhetoric... if you have to ''wonder'' then how can you refute any part of this survey with any authority? But again to humor you... availability of contraception along with frequency of use is a good indicator of attention to women's health care in general and also indicates how much independence a woman has in her culture and society.

4 - ''AIDS may be a significant issue in the third world, but it's not in the developed world IN THE OVERALL SCHEME OF THINGS.'' HIV/AIDS is significant in the third world... That is where SAVE THE CHILDREN does the majority of its work. World wide it is estimated that 11 out of every 1000 adults are infected with HIV. Further it's estimated that 25 million children will be orphans by 2010 because of AIDS. http://www.aids.com/ Still, to suggest that HIV/AIDS is no longer a concern in the developed world is truly shortsighted. I heard on the radio the other day that HIV testing has been suggested as needing to be part of a yearly check up for the whole US population. Too many people have become complacent because more and more people are living longer so projections of HIV infections in the western world are going back up because testing and other safety measures are being ignored.

The survey was never designed as a commentary on the US. To try to deny its results because part of it may be critical of the USA is frightening. I am saddened that critical thought is denied in this country in favor of blind nationalism bordering on jingoism... even when it concerns the results of a WORLD health study for women and children.

You start a thread entitled "US has the 2nd worst newborn mortality rate..." with you stating "If this isn't an indicator that our health care system is in need of reorganization then what is? Even if it's diet or lifestyle these factors still fall under the health care education system."

Now: This study was designed to address third world issues more than the western world so I'm amazed you even ask these questions but...

Exactly.

I have addressed the study and problems with it as pertains to the infant mortality in the US. You've ignored them, preferring to focus on your objection to the wording of my initial reply.

Well, you can't please all of the people all of the time. If you care to address the studies that pertain to infant mortality in the US, please do. Sorry you wasted so much time on irrelevant issues, but you have only yourself to blame there.

J, I made no claims as you are trying to insist... I posted an article about a survey and said If this isn't an indicator that our health care system is in need of reorganization then what is?'' To narrow it down for you... if this isn't an indicator then what is? Show evidence that the survey is faulty yourself. To sit there and say I have to back up the original articles' claim is ludicrous at best. If you want to dispute the results then the burden of proof is on you. Disagree all you want with the survey itself but drop the pretense that there is some significance in the fact that I won't jump when you ask me to.

BTW...Your playing semantical games with the ''Mother's Index'' angle and calling a horse an elephant doesn't change the nature of the beast. Your as bad as Clinton playing the ''what is the definition of IS'' card.

Do you even know what the perameters of the 'Mother's Index'' is?

The report listed 10 measures used to compile the Mother's Index:
Lifetime risk of maternal mortality
Percent of women using modern contraception
Percent of births attended by skilled personnel
Percent of pregnant women with anemia
Adult female literacy rate
Participation of women in national government
Infant mortality rate
Gross primary enrollment rate
Percent of population with access to safe water
Percent of children under 5 with nutritional wasting

Are there any indicators here that you think are unimportant and don't need to be measured? If I were to dispute this then I would question methodology as Evie started to do. Questioning nomenclature is not significant.

Finally, I'm confused with your even focusing on the mothers index anyway... The US is listed in the top 10 out of 125 in this category. Your not happy with the top 10?

cannot back up. He then adopts a posture of anger when called on such tactics. Rob does a lot of the same things.

Just pick a particular mix of measurements, and voila!

What might be interesting to see is a list, by country, of mortality rates (per 1000) of babies born permaturely.

why don't you find it for us?

I posted about the article and its contents. I'm content to discuss what has already been put on the table and the unsubstantiated proposal that the study presents a conspiracy to make the US look bad or, alternatively, that the survey is just bad statistics. I've seen a demonstration of neither.

Are you so sure Save the Children doesn't have a political agenda of its own? Perhaps coinciding with yours?

or just redirecting the subject away from the real implications of the study if it is valid? Why do you and Evie feel so threatened by this study?

BTW... could you please tell me what my agenda is? I thought I was just posting about the results of an alarming survey.

Offended. It is GROSSLY misleading.

Grossly misleading how? Me thinks the Lady doth protest too much.

I've had two 20 page essay finals this week so I'm looking for scholarly documentation here please.

(Actually I'm way burnt out and taking a break from studying for Thursdays exams so it doesn't have to be too scholarly)

Why do you feel threatened by the implications of that question?

I am skeptical about the study because I find it very hard to believe that a woman would be better off having a baby in many other countries at all, much less than she'd be better off than in the US. It doesn't make a lot of sense to me that we are down there with third world backwaters. Does not jibe with the reality I observe. An open mind would question just how such results are reached.

I'm downloading the report now. It will be interesting to see if there is objective data in it to back up their claims or if it is just hype.

I do suspect a political bias on their part (and yours) toward wanting some kind of socialized health care. You seem very committed to that idea for someone who is "just posting about the results of an alarming survey."

It does set off some alarms; hence my skepticism.

I don't know if you think Evie and I get togethger and cook up our responses or something. We don't communicate at all outside of these public forums. We have never met. Maybe the fact that more than one person reaches similar conclusions should spark some skeptical inquiry in you.

I chuckled on this one... Why do you feel threatened by the implications of that question? Answer a question with a question. Wouldn't win a debate tourney but works well in SE.

The comment Maybe the fact that more than one person reaches similar conclusions should spark some skeptical inquiry in you. reminds me of the post I made recently stating that if everyone says your a screw up then you might consider the fact your really are a screw up - a reference to Rumsfield and the angry generals. I believe the response was something about 5 general isn't ''everyone''.

I do suspect a political bias on their part (and yours) toward wanting some kind of socialized health care. You seem very committed to that idea for someone who is ''just posting about the results of an alarming survey.'' Ummm. Did you miss the part about this being a world wide survey that covers 125 countries? BTW... I have never posted in favor of socialized medicine. Find me a post where I say we need socialized medicine and I'll donate to your favorite charity. I'll even email you the receipt.

You and Evie coordinating posts? More than 2 people have been wrong at the same time. Why should this instance be so exceptional? I'm really not that paranoid thank you.

I do applaud your finally downloading the survey rather than just kibitzing about it. I enjoy an informed discussion!

as it seems to be to you.

reminds me of the post I made recently stating that if everyone says your a screw up then you might consider the fact your really are a screw up - a reference to Rumsfield and the angry generals. I believe the response was something about 5 general isn't ''everyone''.

No, if everyone says YOU'RE a screw up then you might consider the fact you really are a screw up.

I think the point REALLY was that 5 generals was only a small fraction of generals, hmmm? Not, as you indicate, everybody.

Not that that has anything to do with the topic at hand.

I supposedly carry a torch for? You ignored that subject this time around.

Why don't you just call me a ''liberal'' and be done with it? Or are you ready to admit that this comment Are you so sure Save the Children doesn't have a political agenda of its own? Perhaps coinciding with yours? was unnecessary. Having been in the health care field for many years is it so far fetched that I may really be concerned when I see such surveys?

How about discussing this... If the survey is substantiated then how is our health care system failing us? Or "the survey is not accurate because of"...? But I grow tired of the automatic partisan knee jerk of ''Hey, their talking smack about the US'' that this thread has devolved to.

Disagree with me all you want Ed, but dropping innuendo like the above comment is not discussion. It's mudslinging by veiled association... which is a game and pardon me for laughing.

Well, at least you finally got around to answering the question, sort of, in a roundabout way, amid all kinds of ridiculous accusations.

I did NOT sling mud or engage in innuendo at all. Calm down.