Health care ratings are misleading

I have heard many reasons the media claims the US doesn't measure up compared to other countries in health care quality. There is the study by the WHO claiming the US ranks 37th in overall quality based on 5 criteria, some of which I find highly questionable. Another one I hear is how much we spend in healthcare, but I want to start out by discussing infant mortality rates.

IMO, the WHOs study lacks credibilty, would like to discuss that later, so I prefer this list, www.cia.gov.... I want to focus specifically on countries in the European union that rank higher than the US in infant mortality per 1000 births, which is almost all of them. Lets narrow it down a bit. According to the results the US is somewhere near the top 20%, while Austria, Germany, Denmark, Belgium and France are all in the top 10%.

The problem with this is different countries used different measures to constitute a still birth. Some use weight, while others use the length of the infant or length of pregnancy to determine a stillbirth, while the US maintians the highest standard. Any sign of life, prior to cutting umbillical cord or removing the placenta.

In www.eurocat.ulster.ac.uk...the statute of limitations for those born alive, but not meeting the criteria for live birth, we get a clearer picture of what I am talking about.

Styria (Austria) Population-based I Province of Styria Late fetal death from a Crown Foot Length>=35cm. From 01.01.95 limit of >=500g introduced by law Up to 1 year

Mainz (Germany) Population-based III Mainz District (Rhineland Palatinate) Weight ***8805; 500g Recorded up to 1 week
Saxony-Anhalt (Germany) Population-based III Federal State Saxony-Anhalt Weight >=500 g introduced by law 1.4.94 (before 1.4.94 >=1000 g) Recorded up to 1 week. Available up to 1 year

Odense (Denmark) Population-based I County of Fünen Gestational age at 28 weeks or more. Up to 7 years for cases seen at paediatric department.

Antwerp (Belgium) Population-based I Province of Antwerp >180 days Recorded up to 1year.
Hainaut (Belgium) Population-based II Provinces of Hainaut (South) & Namur 28 weeks or 180 days Recorded up to 1.

Paris (France) Population-based III Greater Paris 22 weeks after LMP Recorded up to 1 week (hospital discharge)
Strasbourg (France) Population-based III Department of Bas-Rhin Before 1993: 180 days. After 1993: 22 gestational weeks 2 to 5 years

I don't think I have to go into detail the high risk and rate of death when an infant is born premature, so it makes sense they score higher. But even at this disadvantage how close is the US? France, who is the highest on the list of my examples has ~3 less deaths per 1000 births, with up to a five year statute of limitation.

To me that speaks volumes for the US pediatric care industry and says just the opposite of what we hear.

I haven't looked up the statute of limitations for Canada, but the WHO www.gfmer.ch... says an infant must show signs of life after the umbillical cord is cut and the placenta is removed and Canada has 1 less death per 1000 births on the CIA mortality list.

What do you think?


[edit on 15-8-2009 by mhc_70]

[edit on 15-8-2009 by mhc_70]

I appreciate your further analysis of this data. You're correct, international studies can often be misleading.

However, there is a significant distinction between still birth rates and infant mortality. Stillbirth is as you defined it (with the varying standards), but infant mortality is defined as the number of deaths of infant, one year or younger, per 1000 births. Using this accurate definition, the United States does in fact have one of the highest infant mortality rates in the industrialized world.

Without going into too much detail, a primary contributing factor is obesity, which is rampant in the United States.

It is good to further examine things for yourself. You will often find more truth than was initially disclosed, however, when further examining something it is also important to have accurate definitions to ensure an accurate examination. Be proud that you at least took the time to do your own research, it is a skill all should continually refine.

Truthfully,
Shane

Originally posted by randolrs1
I appreciate your further analysis of this data. You're correct, international studies can often be misleading.

However, there is a significant distinction between still birth rates and infant mortality. Stillbirth is as you defined it (with the varying standards), but infant mortality is defined as the number of deaths of infant, one year or younger, per 1000 births. Using this accurate definition, the United States does in fact have one of the highest infant mortality rates in the industrialized world.

Without going into too much detail, a primary contributing factor is obesity, which is rampant in the United States.

It is good to further examine things for yourself. You will often find more truth than was initially disclosed, however, when further examining something it is also important to have accurate definitions to ensure an accurate examination. Be proud that you at least took the time to do your own research, it is a skill all should continually refine.

Truthfully,
Shane

Maybe I am missing something, but if I understand the statute of limitations correctly, in those countries I used in my example, if an infant does not meet their criteria and the infant lives, but dies within the next year, it is still recorded as a stillbirth and not counted as an infant mortality. Therefore, the death is not counted because it is listed as a "stillbirth".

Compared to the US, when the baby emerges, umbillical cord still attached and placenta unremoved, and the infant shows any sign of life it is recorded as a live birth. If, for example, when the umbillical cord is cut and the infant passes, it counts against the US as an infant mortality.