Talk:Infant mortality

This is a very rough first draft of original work that will require a major amount of work. Nancy Sculerati 23:46, 27 May 2007 (CDT)

cross-country comparisons

Before much is done regarding cross-country comparisons of infant mortality rates, it would be useful to have a section on the difficulties of making good comparisons between countries with low infant mortality rates because of the way deaths of very premature babies are counted, and in which babies are counted as stillbirths in which countries. Obviously, a difference in rates of 7 per thousand to 70 per thousand indicates a real difference in conditions, but the difference between countries with an infant mortailty rate of 5 vs 7 per thousand may be purely a statistical artifact. Anthony Argyriou 15:27, 28 May 2007 (CDT)

Actually, Anthony, what you say is more true of other social and economic statistics. In fact, the cross-national comparability of infant mortality rates may well be the highest of any social statistic. The difference between 5 and 7 per 000 is insignificant: the important differences are massive. For example, the range is 3-7 for the richest 30 countries [actually, with USA the highest at 7] and an average of about 5. For lower levels of economic development, there are significant differences. For medium human development [according to UNDP] the range is 8 in Bulgaria to 106 in Swaziland, with an average of 45. For low HD, the range is 47 in Eritrea to 165 in Sierra Leone, with an average of 80 (all 2002 data). If you plot the IMR against per capita GDP, there is a near-perfect correlation of the type that social scientists dream about! So, far from warning about the difficulties of good comparison, there should be a section about the ease of comparison! No doubt the definitions and applications of measuring could be further improved, but as things stand the IMR is a wonderful statistic. --Martin Baldwin-Edwards 17:32, 28 May 2007 (CDT)

Yes, I was starting to get into that in Premature infants, under gestational age. I was reading that in Canada, for example they take the clinical age, where as in the US they take the expected due date as a measure of prematurity.Just that makes a big difference (about 20 plus percent) odf an increase in premature births in the US over Canada. There are other differences that partly account for why the US infant mortality rate is so high, and why the prematurity rate is high also. There is also the question of stillbirth and miscarriage as opposed to neonatal mortality, you are welcome to add the section ifd you like. Nancy Sculerati 17:35, 28 May 2007 (CDT)

Martin, you've exactly proved my point. I noted that large differences are almost always real in my comment; however, when you point out the range of 3 to 7 is insignificant, you then point out that the U.S. is at the top of that range. While I won't claim that the U.S. has the lowest infant mortality of any rich country, the differences in the statistics (what exactly is counted as a live birth, primarily) makes comparison within that range difficult at best, and claiming that U.S. is the rich country with the worst infant mortality is not a supportable conclusion. (The United States does have some factors which make it unlikely to ever have the lowest infant mortality rate, but a truly fair comparison of rates would probably put the U.S. in the middle of rich countries, not at the bottom.)

A specific example: much noise was made when Cuba announced it had an infant mortality rate lower than that of the U.S. However, looking more closely at the statistics, while Cuba and the U.S. have a very similar rate of low-birth-weight babies, Cuba has a much lower rate of extremely-low-birth-weight babies. Most such babies die, both in Cuba and the U.S. However, it's likely, looking at the statistics, that most of those babies are reported as stillbirths in Cuba, while many are reported as live births in the U.S. Many European countries don't report low or extrememly low weight babies as live births unless they survive a certain amount of time after delivery; in the U.S., any baby who shows *any* sign of life after delivery is considered a live birth, even if the baby never manages to breathe, and dies minutes later. In a society whose infant mortality rate is 40 per thousand, these differences won't matter much. But when comparing rates on the order of 3 to 7, these differences can be significant; and as such, league tables of the rich countries are far less meaningful than league tables of all countries for this statistic.

I don't have good sources for these differences - what I've read is mostly second-hand, and I wouldn't consider them reliable sources for the purposes of an entry in CZ, though I do consider them reliable. Anthony Argyriou 11:15, 29 May 2007 (CDT)