America’s shocking infant mortality crisis exposed
The number of infant deaths in the US is at a record high for the second year in a row and is much higher than in comparable countries.
A new report from the CDC found that there were 5.61 per thousand deaths among babies under one year old in 2023, around the same level in 2022, which officials hoped was a blip.
In the US, this rate is up to 75 percent higher than in countries such as Britain and Australia, with experts blaming America’s deepening maternal care crisis.
The leading causes of infant mortality were birth defects, conditions associated with premature birth, cot death, accidental injuries, and maternal illness.
But there were big differences between the states. Mississippi, Arkansas, Louisiana, Ohio and Oklahoma had rates between seven and nine deaths per 1,000 births.
Black babies were found to be at two-fold risk of dying within their first year of life, which experts attribute to poorer maternal health care for black women and a lack of access to doctors in many predominantly black areas.
Other experts blame poor outcomes for all babies on a lack of national insurance, which causes poorer mothers to skip doctor appointments before and after birth.
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This can lead to deadly diseases going unnoticed. For example, in 2023, the CDC reported that the number of cases of babies born with syphilis had increased tenfold in ten years.
If the mothers with syphilis had known they had the condition, they could have had the disease treated during pregnancy to avoid passing the disease on to their child.
Instead, the condition caused 231 stillbirths and 51 infant deaths in 2022.
Dr. Danielle Ely, co-author of the report, told ABC News: “So what we’re seeing is that what we hoped would be just a one-year blip is now a two-year higher rate.”
In 2022, the number of seasonal viruses such as influenza and RSV recovered after leveling off during the quarantine. Both can be fatal to a newborn baby’s fragile immune system.
Dr. Eric Eichenwald, a neonatologist from Philadelphia, told PBS This uptick was “disturbing” and blamed the viruses for the uptick. It is possible that the 2023 figure simply represents the continuation of this trend.
Additionally, demographer Amanda Jean Stevenson, who was not involved in the study, blamed a lack of standardized national care.
Dr. Stevenson told CNN: “We can certainly expect maternal complications to increase overall as many states are not meeting the standard of care for pregnancy-related complications.”
While this rate remained the same nationally from 2022 to 2023, in a few states, such as Nevada and Washington, newborn deaths actually increased, by 31 percent and 16 percent, respectively.
In 2023, there were 34,459 live births and 308 deaths in Mississippi, meaning there were approximately 8.94 deaths for every 1,000 births.
Similarly, in Arkansas there were 35,264 and 290 deaths, which equates to 8.22 deaths per 1,000 births.
In Ohio, there were 126,896 births and 909 deaths, which is 7.16 deaths per 1,000 births.
The above graph shows the infant mortality rate by ethnic group in 2021 (blue) and 2022 (green)
According to the American Journal of Managed Care, as of 2022 the U.S. will have the highest infant mortality rate among comparable developed countries, including Australia, Canada, France, Germany and Japan.
In Britain, 3.9 deaths for every 1,000 births end in an infant death, while in Australia, 3.2 deaths for every 1,000 births end in an infant.
Dr. Sandy Chung, the president of the American Academy of Pediatrics, told CNN: ‘We live in a country with significant resources, so the infant mortality rate and increase are shockingly high.’
The National System of Vital Statisticsthe branch of the CDC that issues this report collected data on birth certificates and researchers sorted them by race, gender, state of residents and ten leading causes of infant mortality.
Maternal diseases include conditions such as preeclampsia, dangerously high blood pressure that affects an estimated 9.5 percent of pregnancies.
Black children were still more likely to die than any other group, followed closely by Native Americans and Native Hawaiians or other Pacific Islanders.
Aside from measuring each state’s overall rates, there were a few states where infant mortality worsened over the year.
Although Nevada and Washington saw the largest increases, rates also rose in states such as Rhode Island, Alabama and Kentucky.
Experts from the National Bureau of Economic Research said this gap between the US and other countries is largely due to two factors.
First, doctors in Europe are more likely to consider babies born after 24 weeks to be miscarried, while the US is more likely to consider them live births.
Second, babies in the US are more likely to be born prematurely or with low birth weight. Both factors can make a baby more likely to die.
Regardless of a national statistic, Dr. Chung that differences in health care from state to state, based on both the number of physicians and the type of public insurance available, may contribute to disparities.
The US regularly surpasses other developed countries in infant mortality.
In some states, women have to drive hours to get to a doctor, meaning they skip checkups during pregnancy and may not even make it to the hospital to give birth.
In Mississippi, for example a 2023 report found that half of women live in a province without access to maternity care. 24 percent of women did not have a birth hospital within 30 minutes of home.
Dr. Chung said, “We know that for people living in or near poverty and for certain racial and ethnic groups, there are significant challenges in accessing a doctor or getting treatment.”
Additionally, research has shown that states that expand Medicaid coverage to mothers in the year after they give birth reduce infant deaths. This is largely because uninsured women are more likely to miss a doctor’s visit after giving birth than women covered by a plan.
Many states have since taken steps to adopt this plan. Arkansas, which ranks in the top five for highest infant mortality rates, did not.
Dr. Chung said, “We need to change policies to lift families out of poverty and help them access health care faster, before it’s too late.”