The truth about Cuba's infant mortality rate

[Arminius]

Cuba vs. the United States on Infant Mortality

By Brian Carnell

Tuesday, February 19, 2002

Recently released statistics on the infant mortality rate in the Western hemisphere yielded an odd conclusions -- Cuba's infant mortality rate, 16 6.0 per 1,000, is now lower than the U.S. infant mortality rate, at 7.2 per 1,000. Given Cuba's poverty level, its 6.0 rate is very impressive, but is it accurate to say that Cuba now has an infant mortality rate lower than the United States? No.

The problem is that international statistics on infant mortality are helpful in revealing large differences, but when it comes to small differences such as that between Cuba and the United States, often other factors are really behind the numbers.

The primary reason Cuba has a lower infant mortality rate than the United States is that the United States is a world leader in an odd category -- the percentage of infants who die on their birthday. In any given year in the United States anywhere from 30-40 percent of infants die before they are even a day old.

Why? Because the United States also easily has the most intensive system of emergency intervention to keep low birth weight and premature infants alive in the world. The United States is, for example, one of only a handful countries that keeps detailed statistics on early fetal mortality -- the survival rate of infants who are born as early as the 20th week of gestation.

How does this skew the statistics? Because in the United States if an infant is born weighing only 400 grams and not breathing, a doctor will likely spend lot of time and money trying to revive that infant. If the infant does not survive -- and the mortality rate for such infants is in excess of 50 percent -- that sequence of events will be recorded as a live birth and then a death.

In many countries, however, (including many European countries) such severe medical intervention would not be attempted and, moreover, regardless of whether or not it was, this would be recorded as a fetal death rather than a live birth. That unfortunate infant would never show up in infant mortality statistics.

This is clearly what is happening in Cuba. In the United States about 1.3 percent of all live births are very low birth weight -- less than 1,500 grams. In Cuba, on the other hand, only about 0.4 percent of all births are less than 1,500 grams. This is despite the fact that the United States and Cuba have very similar low birth rates (births where the infant weighs less than 2500g). The United States actually has a much better low birth rate than Cuba if you control for multiple births -- i.e. the growing number of multiple births in the United States due to technological interventions has resulted in a marked increase in the number of births under 2,500 g.

It is odd if both Cuba and the U.S. have similar birth weight distributions that the U.S. has more than 3 times the number of births under 1,500g, unless there is a marked discrepancy in the way that very low birth weight births are recorded. Cuba probably does much the same thing that many other countries do and does not register births under 1000g. In fact, this is precisely what the World Health Organization itself recommends that for official record keeping purposes, only live births of greater than 1,000g should be included.

The result is that the statistics make it appear as if Cuba's infant mortality rate is significantly better than the United States', but in fact what is really being measured in this difference is that the United States takes far more serious (and expensive) interventions among extremely low birth weight and extremely premature infants than Cuba (or much of the rest of the world for that matter) does.

This does not diminish in any way Cuba's progress on infant mortality, which is one of the few long term improvements that the Cuban state has made, but infant mortality statistics that are that close to one another are often extremely difficult to compare cross-culturally.

Source (http://www.overpopulation.com/articles/2002/000019.html)

[MiDnIgHtMaRaUdEr]

You know just as well as I do that that is pure baseless propaganda. Regardless if premature infants have a higher chance of surviving if born premature, you know as well as I do that once they leave that hospital that the poor are screwed as far as any sort of medical treatment that will not immediately kill the infant.

[Sabocat]

Brian Carnell is a typical conservative right wing piece of trash. Who gives a fuck what he thinks or says?

Just a quick look at his website provides enough information to determine his "agenda".

Right wing jerkoff (http://brian.carnell.com/)

[Arminius]

Can you prove that he is wrong?

[Capitalist Imperial]

Originally posted by [email protected] 5 2004, 03:32 PM
You know just as well as I do that that is pure baseless propaganda. Regardless if premature infants have a higher chance of surviving if born premature, you know as well as I do that once they leave that hospital that the poor are screwed as far as any sort of medical treatment that will not immediately kill the infant.
Translation: I don't want to acknowledge this article becuase it goes against my own baseless propoganda.

[Capitalist Imperial]

Originally posted by [email protected] 5 2004, 04:17 PM
Brian Carnell is a typical conservative right wing piece of trash. Who gives a fuck what he thinks or says?

Just a quick look at his website provides enough information to determine his "agenda".

Right wing jerkoff (http://brian.carnell.com/)
1) ad hominem attack.

2) fallacy of diversion, attacking the source in lieu of the actual argument.

This is a good article, and it seems that you commie pukes have not a foot to stand on. This is especially poignant because many leftists have hung their hat on Cuba's Infant mortality rate being better than America's.

However, it appears that this article makes perfect sense, and has some good logic to support it's assertion (whch is something that leftists don't seem to have in response to this).

[YKTMX]

Infant mortality rate is higher in a small, isolated, bureaucratic Carribean island than it is in the Richest country in the world?

It seems like Marx was wrong all along! :(


I'm off to join the Labour Party!

[Sabocat]

I could counter with this:


Racism and poverty killing more babies
By Heather Cottin

For the first time in over 40 years, the overall infant mortality rate in the U.S. has increased, according to a report just released by the federal government's Centers for Disease Control and Prevention.

Infant mortality is seen as a basic measure of a society's well-being. The latest information--which compares 2002 to the previous year--shows that the risk of death before an infant's first birthday increased from 6.8 to 7 per 1,000 live births. This seemingly small rise is statistically very significant and surprised health officials. It means babies born in this wealthy country are more at risk than in many underdeveloped nations.

But the overall figures don't tell the whole story. While the rate increased for both African American and white infants, the gap between the two is wide and growing. Among whites, the mortality rate climbed from 5.7 to 5.9 deaths per 1,000 births. The rate among Black babies, however, went from a shocking 14 to 14.3 deaths during the same period.

The Black infant mortality rate is at a crisis level that reflects crushing conditions of racism and poverty in the United States. Some call it "genocide."

Health officials said the overall increase may have reflected improvements in technology that allow more pre mature babies to be born, as well as women waiting until they are older before having their first child. But this does not explain the large gap between Black and white rates.

The CDC report does not address the problems of food insecurity, homelessness and the decline of social services that affect the poor.

However, Dr. Dennis Andrulis of Downstate Medical Center on Long Island said the crisis could be tied to an economic downturn that "took root in 2000 or 2001 but only manifested itself in 2002. ... People in the cities with limited access to health care start facing higher rates of unemployment and poverty, they worry more about putting food on the table and less about going to see the doctor." (New York Times, Feb. 12)

In July 2002, the CDC reported increases of low and very low birthweight among Black infants.

The 2000 Census showed that the states with the highest rates of Black infant mortality were Iowa with 20.6, Arizona with 19.1 and Washington, D.C., with 19.0 per 1,000 live births.

The gap extends to mothers, too. The Alan Guttmacher Institute has noted that Black women are almost four times as likely as white women to die from pregnancy-related causes. (August 2003)

Ellen Catalinotto, a nurse-midwife at New York's Columbia Presbyterian Hospital, told WW that "The maternal mortality rate among Black women is three times that of whites. And, even in the absence of identifiable diseases, Black women have higher incidences of low birthweights among their babies. There are so many uninsured and underinsured people in the United States," she continued, "women don't go for prenatal care. The U.S. lags behind 26 other countries in infant mortality. It has the worst record of all the industrialized countries."

Catalinotto noted that doctors are performing more Caesarian sections, which now account for 25 percent of births in the U.S. The risk of death for mothers during a C-section is three times higher than for normal births.

Cuba, where the infant mortality rate has been reduced to 6.2, lower than the U.S., has been sending doctors and medical assistance to Haiti, which has the highest infant mortality rate in the Western hemisphere. Cuban Foreign Minister Felipe Perez Roque recently reported that in Haiti, "In the areas covered by the Cuban doctors, the infant mortality rate in children under 1 year of age has dropped from 80 to 28 per 1,000 live births--and in children under 5 years of age, the rate has fallen from 159 to 39 per 1,000 live births. The maternal mortality rate dropped from 523 deaths to 259 per 100,000 live births."

Socialist Cuba's extraordinary advances in cutting infant mortality rates, and its commitment to improving medical services in the Third World, stand in contrast to the indifference of the U.S. capitalist government and medical establishment to the deaths of over 28,000 babies in the United States each year, many of whom are Black and poor.

"Infant and maternal mortality is related to the standard of living and a system of support. There are no rights for pregnant women in the United States. No maternal leave, nutrition, health care. There is not a single law that protects them," Catalinotto said.

"Infant mortality is a measure of society's commitment to women and children, in terms of access to health care and protection of the mother and child."

The savagery of U.S. capitalism and racism offer no such protection for women and children.

Link (http://www.workers.org/ww/2004/infmort0226.php)

Regardless of how the first article tries to twist the statistics, it's fairly clear that the U.S. under any measurment currently being used, is experiencing an increase in infant mortality, while Cuba has experienced a decrease.




ATLANTA, Georgia (AP) -- U.S. infant mortality has climbed for the first time in more than four decades, mainly because of complications associated with older women putting off motherhood and then having multiple babies via fertility drugs, the government said Wednesday.

At the same time, U.S. life expectancy reached an all-time high of 77.4 years in 2002, the Centers for Disease Control and Prevention said. Life expectancy in 2001 was 77.2 years.

The nation's infant mortality rate climbed from 6.8 deaths per 1,000 live births in 2001 to 7.0 deaths per 1,000 in 2002.

CDC analysts had expected another year of decline -- the last time the rate rose was in 1958.

Link (http://www.cnn.com/2004/HEALTH/parenting/02/11/infant.mortality.ap/)


Wouldn't it stand to reason that the U.S. with easy, unlimited access to drugs, materials, hospital equipment, would have lower infant mortality? The writer of the first article is implying that the standard for measuring in Cuba is different than in the U.S. but there is simply no proof that is true. The CDC, UN, and Unicef use the standard number rating per thousand. If there was an inconsistency in tabulation, don't you think they'd point it out or footnote it ?

[Sabocat]

Originally posted by Capitalist [email protected] 5 2004, 01:41 PM
1) ad hominem attack.

2) fallacy of diversion, attacking the source in lieu of the actual argument.

This is a good article, and it seems that you commie pukes have not a foot to stand on. This is especially poignant because many leftists have hung their hat on Cuba's Infant mortality rate being better than America's.

However, it appears that this article makes perfect sense, and has some good logic to support it's assertion (whch is something that leftists don't seem to have in response to this).
How is an op-ed piece by a conservative writer an authority on birth rate mortality?

None of the birth rate mortality statistics listed by any agency footnote Cuba's numbers with a note on tabulation inaccuracies. The article is pure conjecture on his part with no facts to support it.

[Arminius]

Regardless of how the first article tries to twist the statistics, it's fairly clear that the U.S. under any measurment currently being used, is experiencing an increase in infant mortality, while Cuba has experienced a decrease.

And this refutes Carnell's argument how?


Wouldn't it stand to reason that the U.S. with easy, unlimited access to drugs, materials, hospital equipment, would have lower infant mortality?

No as per the reasons Carnell pointed out in his article.

[Sabocat]

Show me in that article proof that Cuba does not report births below a certain weight.


Because in the United States if an infant is born weighing only 400 grams and not breathing, a doctor will likely spend lot of time and money trying to revive that infant. If the infant does not survive -- and the mortality rate for such infants is in excess of 50 percent -- that sequence of events will be recorded as a live birth and then a death.

Prove that this is different than Cuba.



It is odd if both Cuba and the U.S. have similar birth weight distributions that the U.S. has more than 3 times the number of births under 1,500g, unless there is a marked discrepancy in the way that very low birth weight births are recorded. Cuba probably does much the same thing that many other countries do and does not register births under 1000g. In fact, this is precisely what the World Health Organization itself recommends that for official record keeping purposes, only live births of greater than 1,000g should be included.

Pure conjecture. Prove that Cuba does "much the same thing".


difference is that the United States takes far more serious (and expensive) interventions among extremely low birth weight and extremely premature infants than Cuba

Prove it.

[Fidel Castro]

one of the few long term improvements that the Cuban state has made

This pretty much rounds up the authors view I think

[Vinny Rafarino]

Can you prove that he is wrong?


What exactly is there to "prove wrong"? Let's look at the author's own words to begin with:

"This is clearly what is happening in Cuba"

What exactly does this statement mean?

It's very simple, it means "there is no actual proof to suggest this is what is happening in Cuba but this is what I think.

For all the fluffing of the USA as "easily having the most intensive system of emergency intervention to keep low birth weight and premature infants alive in the world", the author does not explain why the USA ranks 35th in the global infant mortality scale.

The USA even ranks behind such former "commie states" as Slovenia and the Czech Republic.

Why does the author not attempt to create a conspiracy as to why a Slovenia has an infant mortality rate that is nearly two full points lower than the USA?

[Source, United States Central Intelligence Agency,]

It's quite simple, now that the Slovenes call themselves a "parliamentary democratic republic" and voted to join both NATO and the EU, they are now "friends of the West" and beyond right-wing, conservative riducule.

What we really have to consider is this, why would anyone believe US propagandists when their own country has completely ignored the Cuban Health Minister's report of a 6.3 IMR rate cuba and has completely fabricated a number for Cuba (7.15) so that they will show as a couple of spots behind the USA at 35. (37th, right behind the war torn but US friendly nation of Croatia :lol: )

We are not even going to talk about how Cuba's doctor to patient ratio dwarfs that of the USA. (and the rest of the world that is)


No as per the reasons Carnell pointed out in his article.

How can you prove that Carnell did not simply make these "reasons" up? You can't of course, thats why it's called an OP/ED.

If you have any proof to these assumptions beyond pure speculation, I will be more than happy to debate you on them.

Until then keep own truckin' parner'.