Tuesday, May 7, 2013

Save the Children

The non-governmental organization Save the Children has just released its "State of the World's Mothers-2013" that includes a foreword by Melinda Gates (whose foundation helped support the effort), adding to its gravitas. There are at least three important themes in the report: (1) children and their mothers are still at higher risk of death than they should be, given what we know about saving lives; (2) there is nonetheless global progress being made, and we have to continue to push that agenda; and (3) the US does worse on this than virtually any other developed nation. Messages 1 and 2 were drowned out in the media by message 3, which was sensationalized a bit on NBC News:
The U.S. is a worse place for newborns than 68 other countries, including Egypt, Turkey and Peru, according to a report released Tuesday by Save the Children.
A million babies die every year globally on the same day they were born, including more than 11,000 American newborns, the report estimates. Most of them could be saved with fairly cheap interventions, the group says.
That first point is simply not true. It distorts the facts. The US is doing less well than it should, but newborns are not at higher risk of death than are babies in Egypt, Turkey, or Peru. The report calculates rates of mortality on the first day of life per 1,000 live births and on that very specific rate, the US is, to be sure, tied with Egypt, Turkey, and Peru at 3 per 1,000. But, if you then look at neonatal mortality rates (deaths in the first month of life per 1,000 live births), the US rate is 4, compared to 7 in Egypt, 9 in Turkey, and 9 in Peru. For most countries, the first day mortality rates are based on simulation models, not on real data, so it is not clear to me why they would emphasize this so much, except for the sake of getting attention.

Still, it is worth emphasizing that infant mortality rates in the US are among the highest in developed nations. This is not news, as I have noted it before, and the main culprit is pre-term births. Data from the Centers for Disease Control consistently point out that pre-term births are highest among non-Hispanic Blacks, the majority of whom are born to unmarried mothers, and a disproportionate share of whom are teenagers. There's work to do here.

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