Gone Too Soon What’s Behind the High U.S. Infant Mortality Rate - 2013 FALL - Stanford Medicine Magazine - Stanford University S
THE ROOT CAUSE
Over most of the 20th century, infant mortality rates in the United States and other industrialized nations steadily declined thanks to improving medical knowledge and technology. Hospitals established neonatal intensive care units for infants born with health problems, women began taking folate supplements to decrease the occurrence of certain birth defects and pediatricians learned the best sleeping positions for babies to prevent sudden infant death syndrome. And compared with much of the world — African countries like Somalia and Mali with infant mortality rates around 10 percent and South American countries like Honduras and Ecuador with rates over 2 percent — the United States wasn’t faring poorly.
But by the end of the century, the declines had slowed, the United States lagged behind other developed countries, and it was becoming clear that a drastic socioeconomic divide existed even within the United States when it came to infant mortality. According to the CDC, African Americans had — and continue to have — almost double the rate of infant deaths as Caucasians, and babies born in Mississippi and Alabama are more than twice as likely to die in their first year of life as babies born in Massachusetts and Vermont. (The differences between states reflect, in part, differences in the racial and ethnic makeup of their populations.)
Five main causes of mortality play into the statistics for babies under a year old: birth defects, sudden infant death syndrome, maternal health complications, unintentional injuries and preterm-related causes of death. But when scientists, including Wise and MacDorman, have crunched the numbers on infant mortality, they find that one factor is the biggest difference maker between the United States and other industrialized countries: premature births.