4 ms·

That's a great example. I have a family member who works in the health care data field, with the idea that enough data leads to better diagnosis and better outc

That's a great example. I have a family member who works in the health care data field, with the idea that enough data leads to better diagnosis and better outcomes. The topic of maternal mortality came up and how the US, comparatively, is rated worse than every other 1st world nation. His take was that 1) the other countries aren't reporting deaths correctly, 2) the data definition is not the same across nations, and 3) US women entered pregnancy with more comorbidities. So in essence a person in a medical field intended to keep more people alive for longer failed to recognize that systemically the US is doing worse than other nations because "data is deficient" and then blamed the dying women for being fat, old, unhealthy. Read here minorities specifically. Apparently no other nations in the world have old, fat, or unhealthy pregnant women.

SketchySeaBeast 8y ago
That's an excellent example of pushing agency back upon the patient. And I'm confused how "dying from complications directly caused by childbirth" would be reported differently in other countries. Maybe that's why Sweden has such a low murder rate, it's not "death by gunshot", it's "spontaneous exsanguination during a hospital stay".
- rabboRubble 8y ago
  I think the US has fairly broad definitions of maternal mortality, i.e. death within 3 months or 1 year of birth or something like that. Some deaths related to the childbirth happen after the birth is officially over. Think sepsis from c-section complications or untreated post-partum leading to suicide.
  - SketchySeaBeast 8y ago
    Yeah, I took a look and that's exactly it - the US records over a year and the rest of the world a lot lower, so that could pick some stuff up. But I don't think that explains the higher mortality - I imagine the longer one lives after childbirth, the better odds one has that they will continue to live longer, and it certainly doesn't explain why minorities have so much of a higher rate.
jessaustin 8y ago
My understanding is that mortality for whites is actually comparable to other nations. It is specifically the mortality of nonwhites that is so terrible. It's actually more specific than that: immigrant minorities are fine, but the second generation has the increased mortality of other nonwhites in USA. I heard this on some podcast; it may have been "Reveal"?
Bramble 8y ago
While some of these figures might actually be due to faulty data or divergent definitions in other nations, there is another factor that neither you nor your friend seem to be acknowledging - how the high cost of health care in this country is impacting the way women seek care during, before, and after childbirth. Giving birth in this country is extremely expensive (https://www.theguardian.com/us-news/2018/jan/16/why-does-it-cost-32093-just-to-give-birth-in-america https://www.theguardian.com/us-news/2018/jan/16/why-does-it-...) and we have a ton of people who are uninsured, underinsured, have high deductible plans, or simply aren't in stable enough financial situations to risk going to the doctor for prenatal/postnatal care when the $40 copayment or $300+ tests the doctor runs could delay their rent check that month. When you talk about people coming into the hospital with comorbitieis, it's an easy next step to say "eh not our fault, that's on the patient, not on the medical system," but it kind of is on the medical system (or the insurance system, if you choose to differentiate the two) if the inability to afford healthcare is causing so many people to die of secondary causes when something serious enough to warrant it (in this case, pregnancy) forces them to go to a hospital.

SketchySeaBeast 8y ago

That's an excellent example of pushing agency back upon the patient. And I'm confused how "dying from complications directly caused by childbirth" would be reported differently in other countries. Maybe that's why Sweden has such a low murder rate, it's not "death by gunshot", it's "spontaneous exsanguination during a hospital stay".

rabboRubble 8y ago
I think the US has fairly broad definitions of maternal mortality, i.e. death within 3 months or 1 year of birth or something like that. Some deaths related to the childbirth happen after the birth is officially over. Think sepsis from c-section complications or untreated post-partum leading to suicide.
- SketchySeaBeast 8y ago
  Yeah, I took a look and that's exactly it - the US records over a year and the rest of the world a lot lower, so that could pick some stuff up. But I don't think that explains the higher mortality - I imagine the longer one lives after childbirth, the better odds one has that they will continue to live longer, and it certainly doesn't explain why minorities have so much of a higher rate.

jessaustin 8y ago

My understanding is that mortality for whites is actually comparable to other nations. It is specifically the mortality of nonwhites that is so terrible. It's actually more specific than that: immigrant minorities are fine, but the second generation has the increased mortality of other nonwhites in USA. I heard this on some podcast; it may have been "Reveal"?

Bramble 8y ago

While some of these figures might actually be due to faulty data or divergent definitions in other nations, there is another factor that neither you nor your friend seem to be acknowledging - how the high cost of health care in this country is impacting the way women seek care during, before, and after childbirth. Giving birth in this country is extremely expensive (https://www.theguardian.com/us-news/2018/jan/16/why-does-it-cost-32093-just-to-give-birth-in-america https://www.theguardian.com/us-news/2018/jan/16/why-does-it-...) and we have a ton of people who are uninsured, underinsured, have high deductible plans, or simply aren't in stable enough financial situations to risk going to the doctor for prenatal/postnatal care when the $40 copayment or $300+ tests the doctor runs could delay their rent check that month. When you talk about people coming into the hospital with comorbitieis, it's an easy next step to say "eh not our fault, that's on the patient, not on the medical system," but it kind of is on the medical system (or the insurance system, if you choose to differentiate the two) if the inability to afford healthcare is causing so many people to die of secondary causes when something serious enough to warrant it (in this case, pregnancy) forces them to go to a hospital.