6 ms·

Last time I looked closely at infant mortality in the US, it looked like the US was doing horribly. However, after talking with some doctors at a neonatal ICU I

by troupe 6y ago

Last time I looked closely at infant mortality in the US, it looked like the US was doing horribly. However, after talking with some doctors at a neonatal ICU I found out that in the US, we will often identify an unborn child that is in trouble and get it out of the mother in an attempt to save it. Since these types of cases are considered a birth, they count against the mortality rate whereas in some other countries they would be stillborn and not count against infant mortality statistics. That isn't to disagree with the causes given in the article, but after talking to those doctors it made me realize how complicated it is to get accurate comparisons between countries.

OJFord 6y ago
That's interesting, but for 'life expectancy' my understanding is that it's the expectation for an X year old, where X is something like 12 or 20 that I can't remember - designed to eliminate such effects, and instead indicate the environmental impact. Edit: apparently I'm wrong, Wikipedia states that 'life expectancy at birth (LEB) is the most commonly used measure'.
- nraynaud 6y ago
  Just to confirm, if it's not qualified, it's implied "at birth".
socialdemocrat 6y ago
As far as I recollect discussing this before one will actually save younger children in most of Nordic countries e.g. than in the US, and infant mortality rate is still much lower. There are several reasons the US rate is so much higher than in other developed countries. The US does not have universal health care, which means large sections of the US population does not get adequate follow up during pregnancy. If you look at health care for the poor in the US, it is generally geared towards emergency care. They will stitch you up if you are about to die. However it generally does not cover regular doctor visits and checkups. Hence in the US a lot of expensive effort goes into saving babies when born, when the problem could far more easily have been resolved early in the pregnancy with better checkups. The US system is simply not very geared towards simple preventative care. Where other health care systems tend to focus on simple cheap system. American health care is overly focused on advance equipment, complicated procedures and basically anything which gives a lot of prestige or profits. Problem is that such a health care system does not perform very well in the real world. You end up with very high costs and poor results. E.g. a lot of health problems in the US is actually caused by over-treatment. That is the irony of the US system. Poor people who need help don't get it. People with expensive health care plans OTOH are subject to invasive procedures they don't need because it brings in profit. E.g. the US has overuse of surgery. So basically people who don't need surgery are cut open in the US. And that does take a toll on your health. The opioid crisis killing Americans is a variation of this. Basically it is overmedication for the sake of profits. The health care system is actually a contributor to the bad health problems in the US. It really should lead people to question for-profit health care, but it seems impossible to question anything about capitalism in the US. You speak to deaf ears.
- gleb 6y ago
  Except that US does have universal healthcare for pregnant women. Most pregnancies and births in United States are covered by Medicaid. And Medicaid pays well for that.
  - Blahah 6y ago
    It really isn't the same though. In most developed countries you don't have to worry about turning up to a hospital, for pregnancy or any reason. When a pregnant woman turns up to hospital in the UK (for example) she is absolutely not stressed about the potential cost of the care. If something goes wrong, she gets world class care at no cost to her. If some other medical problem is discovered while she's there, it will be diagnosed and treated and she doesn't have to stress about the cost. Not so in the US. It would be surprising if that alone didn't account for a significant number of adverse outcomes.
    - ars 6y ago
      > Not so in the US Yes so in the US. That's literally what the person you replied to just told you: For pregnant women, children, and poor people, it's all fully covered. It's really only the middle class that has it hard (i.e. expensive).
      - Blahah 6y ago
        No, it isn't literally what they told me. In many other countries, there is no possibility of being charged for any medical treatment you require when you visit hospital to give birth. It is free as in you don't need to have any money or any way to pay and you can be diagnosed and treated for any medical condition that might become relevant while you're there giving birth, and give birth and have any related issues handled, and you never have to pay anything at all. In the US, that is just not true [1]. 1: https://www.theatlantic.com/health/archive/2020/01/how-much-does-it-cost-have-baby-us/604519/ https://www.theatlantic.com/health/archive/2020/01/how-much-...
        6y ago
toomanybeersies 6y ago
Another statistic that's difficult to compare is homelessness. On first glance, New Zealand (0.94%) and Australia (0.48%) top the OECD for rate of homelessness, as they include people living in temporary accomodation (sleeping on a couch, motels, etc.) or cars as homeless. Whereas Japan (with the 0.00%) only counts people sleeping rough). Comparing unemployment rates has similar issues. Comparing these kinds of rates between countries on an absolute basis is largely useless. However, the change in these rates can give insight on how events (political, economic, etc) have changed the demographics and socioeconomic status of countries.
- lostlogin 6y ago
  Comparing stats is fraught. There was a really good thread here on HN about how the US calculates its unemployment rate, it is vastly different to how I naively imagined it was calculated. https://news.ycombinator.com/item?id=24836422 https://news.ycombinator.com/item?id=24836422
  - gok 6y ago
    Note that the current calculation is also what's used almost everywhere else in the developed world; the US figure was changed to be more comparable to other countries in the 2000s.
  - rrrrrrrrrrrryan 6y ago
    U-3 is used specifically because we have so much historical data - it lets us compare how we're doing now to the great depression, for example, and up until a few decades ago it was fine because all the various unemployment metrics were strongly correlated. Politicians eventually gamed the metric so hard that it's almost worthless now, so economists today mostly use U-6.
laurencerowe 6y ago
Similar gaps between the US and comparable countries are apparent at age 40 too: https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/#item-le_life-expectancy-in-years-at-given-age-2017_dec-2019-update https://www.healthsystemtracker.org/chart-collection/u-s-lif...
wdr1 6y ago
I wish they would report on life expectancy from 1 year at birth to eliminate the variance in what each country considers a live birth.

by troupe 6y ago

OJFord 6y ago

That's interesting, but for 'life expectancy' my understanding is that it's the expectation for an X year old, where X is something like 12 or 20 that I can't remember - designed to eliminate such effects, and instead indicate the environmental impact. Edit: apparently I'm wrong, Wikipedia states that 'life expectancy at birth (LEB) is the most commonly used measure'.

nraynaud 6y ago
Just to confirm, if it's not qualified, it's implied "at birth".

socialdemocrat 6y ago

As far as I recollect discussing this before one will actually save younger children in most of Nordic countries e.g. than in the US, and infant mortality rate is still much lower. There are several reasons the US rate is so much higher than in other developed countries. The US does not have universal health care, which means large sections of the US population does not get adequate follow up during pregnancy. If you look at health care for the poor in the US, it is generally geared towards emergency care. They will stitch you up if you are about to die. However it generally does not cover regular doctor visits and checkups. Hence in the US a lot of expensive effort goes into saving babies when born, when the problem could far more easily have been resolved early in the pregnancy with better checkups. The US system is simply not very geared towards simple preventative care. Where other health care systems tend to focus on simple cheap system. American health care is overly focused on advance equipment, complicated procedures and basically anything which gives a lot of prestige or profits. Problem is that such a health care system does not perform very well in the real world. You end up with very high costs and poor results. E.g. a lot of health problems in the US is actually caused by over-treatment. That is the irony of the US system. Poor people who need help don't get it. People with expensive health care plans OTOH are subject to invasive procedures they don't need because it brings in profit. E.g. the US has overuse of surgery. So basically people who don't need surgery are cut open in the US. And that does take a toll on your health. The opioid crisis killing Americans is a variation of this. Basically it is overmedication for the sake of profits. The health care system is actually a contributor to the bad health problems in the US. It really should lead people to question for-profit health care, but it seems impossible to question anything about capitalism in the US. You speak to deaf ears.

gleb 6y ago
Except that US does have universal healthcare for pregnant women. Most pregnancies and births in United States are covered by Medicaid. And Medicaid pays well for that.
- Blahah 6y ago
  It really isn't the same though. In most developed countries you don't have to worry about turning up to a hospital, for pregnancy or any reason. When a pregnant woman turns up to hospital in the UK (for example) she is absolutely not stressed about the potential cost of the care. If something goes wrong, she gets world class care at no cost to her. If some other medical problem is discovered while she's there, it will be diagnosed and treated and she doesn't have to stress about the cost. Not so in the US. It would be surprising if that alone didn't account for a significant number of adverse outcomes.
  - ars 6y ago
    > Not so in the US Yes so in the US. That's literally what the person you replied to just told you: For pregnant women, children, and poor people, it's all fully covered. It's really only the middle class that has it hard (i.e. expensive).
    - Blahah 6y ago
      No, it isn't literally what they told me. In many other countries, there is no possibility of being charged for any medical treatment you require when you visit hospital to give birth. It is free as in you don't need to have any money or any way to pay and you can be diagnosed and treated for any medical condition that might become relevant while you're there giving birth, and give birth and have any related issues handled, and you never have to pay anything at all. In the US, that is just not true [1]. 1: https://www.theatlantic.com/health/archive/2020/01/how-much-does-it-cost-have-baby-us/604519/ https://www.theatlantic.com/health/archive/2020/01/how-much-...
      - 6y ago

toomanybeersies 6y ago

Another statistic that's difficult to compare is homelessness. On first glance, New Zealand (0.94%) and Australia (0.48%) top the OECD for rate of homelessness, as they include people living in temporary accomodation (sleeping on a couch, motels, etc.) or cars as homeless. Whereas Japan (with the 0.00%) only counts people sleeping rough). Comparing unemployment rates has similar issues. Comparing these kinds of rates between countries on an absolute basis is largely useless. However, the change in these rates can give insight on how events (political, economic, etc) have changed the demographics and socioeconomic status of countries.

lostlogin 6y ago
Comparing stats is fraught. There was a really good thread here on HN about how the US calculates its unemployment rate, it is vastly different to how I naively imagined it was calculated. https://news.ycombinator.com/item?id=24836422 https://news.ycombinator.com/item?id=24836422
- gok 6y ago
  Note that the current calculation is also what's used almost everywhere else in the developed world; the US figure was changed to be more comparable to other countries in the 2000s.
- rrrrrrrrrrrryan 6y ago
  U-3 is used specifically because we have so much historical data - it lets us compare how we're doing now to the great depression, for example, and up until a few decades ago it was fine because all the various unemployment metrics were strongly correlated. Politicians eventually gamed the metric so hard that it's almost worthless now, so economists today mostly use U-6.

laurencerowe 6y ago

Similar gaps between the US and comparable countries are apparent at age 40 too: https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/#item-le_life-expectancy-in-years-at-given-age-2017_dec-2019-update https://www.healthsystemtracker.org/chart-collection/u-s-lif...

wdr1 6y ago

I wish they would report on life expectancy from 1 year at birth to eliminate the variance in what each country considers a live birth.