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Where in the world are babies at the lowest risk of dying?
- homeless_engi 1y agoTl;dr: Japan
- insane_dreamer 1y agomore precisely: Japan at the top, US at the bottom (among wealthy countries)
- FirmwareBurner 1y agoCould it be that Japan is so incredibly clean everywhere? Metro stations there feel as clean as hospitals. Everyone wearing masks, etc.
- pixl97 1y agoProbably not. It's much more likely more resources being provided during pregnancy, the country is very concerned about its current fertility rate.
- mystified5016 1y agoMore that the government understands they have a vested interest in caring for (as opposed to exploiting) its population. That's why the US is always at the very bottom of rankings like this.
- rwmj 1y agoYes it's very obvious having spent much time in Japan that the government actually works for the people instead of regarding them as an inconvenience.
- FirmwareBurner 1y agoIf the Japanese gov actually cared about its people, they would enforce some overtime regulations on companies.
- Muromec 1y agoThat's like most rich countries with more or less democratic government. US is just corrupt to the levels only achievable by Eastern Europe.
- rayiner 1y agoThe U.S. has beginning to end health care for pregnancy and child birth. Its infant mortality rate (5.4) isn’t really much higher than Canada (4.7), which has a socialized healthcare system.
- const_cast 1y agoWhich seems kind of okay, except when you consider that we pay significantly more per-capita for healthcare as opposed to Canada. Yes, that includes if you take into account taxes, and it's not even close. Sure, we're not the absolute worst, but we are the most expensive. And, for that, we get close to the worst results. Clearly, our healthcare system is broken in a variety of complex ways.
- rayiner 1y agoAs far as I can tell, we pay more for healthcare for the same reason we pay more for schools and more for subways. We’re a low competence, low trust society, and have to compensate for it by making everything subject to litigation to the point where the country is effectively run by lawyers. My six year old boy ran into a table and got a black eye. Took him to the doctor (because my wife made me), who physically examined him and saw he was fine. But ordered a CT scan anyway (which we got the same morning because this is America). No sane healthcare system would order a CT scan for this! But in our litigation-driven system, the doctor has to do it, because in the extremely unlikely situation that there was an undetected internal bleed, he’d get sued. And some expert would get on the stand and say the standard of care is to order a CT scan every time a six year old boy does a six year old boy thing.
- const_cast 1y agoI don't think this is the sole reason why, I think private sector inefficiency is a big reason why, too. We have an extremely fragmented system that breeds inefficiency. Thousands of insurers, so hospitals have hundreds of billing specialists. Thousands of plans, so the complexity of what is and isn't covered explodes beyond belief. There's no streamlining, no centralization, no authority. Just bickering and "erm, ackshually" from every party. Every interaction has extremely high friction that comes with a massive, fragmented system. It's like a microservice architecture with thousands and thousands of microservices. Except their contracts aren't always published, sometimes you need to call them on the telephone. And sometimes you just have to try requests and see if they get denied. Also, I think a CT for head injury is fairly standard practice. I think they do that in Europe. Anyway I had some pain somewhere inconspicuous once and it was cancer, so. I don't think the issue is we image too much.
- bamboozled 1y agoThey have a lot of pediatric doctors compared to the number of babies born, thus babies are receiving more attention ?
- otherme123 1y agoAlso parents being paid for raising their babies.
- TrackerFF 1y agoBut more interestingly, Japan and the Nordics. Interesting in the sense that the Nordics have a vastly different healthcare system than Japan.
- ty6853 1y agoI have no idea how this tracks to births, but I did some studies before of Nordic homicide rate, and if you drop an actual Nordic citizen in similarly white homogenous states like new hampshire their murder rate isn't terribly worse than it is in a Nordic nation. My hypothesis is there may be something like this effect happening, where once you control for nordic people in similarly white states I bet they'd have much closer to nordic birth risk.
- tokai 1y agoWhat about looking at economic strata instead at ethnicity?
- ty6853 1y agoSure, take a look at Bahamas or Seychelles, "rich" black countries almost as high GDP per capita as some of the nordic nations (PPP adjusted in Seychelles case). Still with infant mortality in the relative shitter. Or compare hispanic to blacks at similar income in USA, they knock them out the park on infant mortality.
- keybored 1y ago> Sure, take a look at Bahamas or Seychelles, "rich" black countries almost as high GDP per capita as some of the nordic nations. Still with infant mortality in the relative shitter. The Seychelles Gini coefficient is higher than Sweden. There doesn’t seem to be data on the Bahamas.
- ty6853 1y agoNot by much. 0.32 vs 0.30 by this estimate https://ourworldindata.org/grapher/economic-inequality-gini-index https://ourworldindata.org/grapher/economic-inequality-gini-...
- _DeadFred_ 1y agoHistorically (at least up until the late 90s) Japan, France and maybe others had a much different point of death included as death at birth that skewed infant mortality numbers. I'd like to see more than a bullet point 3 to understand how/when that was changed.
- fakedang 1y agoWhat's the point of using OECD data anymore when countries like India, China, MENAPT and Indonesia are excluded? Any study that uses OECD data should be disqualified as a shit study outright.
- insane_dreamer 1y agoBecause it's more useful to compare wealthier countries with other wealthier countries (not by total size of the economy), for these types of metrics. But yes, I agree it would have been interesting to see India and China for comparison (and in fact, they are listed in the OECD report that was linked to in the article). Update: I noticed that in the linked to OECD report, only the OECD countries, plus Romania, report the same 22-week threshold. That may be why those countries were picked (for a proper comparison with the same IVs.)
- kspacewalk2 1y agoSeems to me that data quality and consistency is much more important than the number of countries. If China or Indonesia collect data of similar quality and consistency - by all means, OECD + these countries will make for a better dataset. If not, mixing shit data with good data is a better indicator of a "shit study".
- fakedang 1y agoThen the title of the article ought to be "Where in the developed world are babies at the lowest risk of death?". Straight up ignoring more than 50% of the world's population in one go, lmao. For the record, I'm pretty sure most of the world has caught up on methods to gather mortality data, especially all of the countries I had mentioned.
- ty6853 1y ago>"Where in the developed world are babies at the lowest risk of death? Where there are fewer black people or native americans. In the US it almost follows to a T a heat map of where black people and reservations are. Except the places where there are enough hispanics to counter balance them, because for whatever reason hispanic identifying populations do comparatively quite well even with lower incomes.
- timewizard 1y agoIsn't the more appropriate question is where in the world are babies AND mothers at the lowest risks during all 9 months of gestation and then childbirth?
- smeej 1y agoIt's certainly another question, but the question of appropriateness seems to depend on context. I don't see what would make either more appropriate than the other in terms of "things a data analysis website might assess"?
- timewizard 1y agoIf you're improving newborn mortality by harming the mothers mortality then your model, at the very least, should not be blindly replicated.
- Retric 1y agoThat and any other interesting info is going to be swamped by natural abortions which end a large fraction of all human pregnancies ~40% everywhere.
- smeej 1y agoThis article is only about the survival of children born alive. Not saying that other question isn't worth looking at too. It's just a separate one from the one in this article.
- insane_dreamer 1y agoIt would be interesting to see infant mortality rate as a function of GDP per capita -- that would tell you which countries make best use of their wealth to ensure the health of their citizens' children. (It's not hard to guess which country would come out looking even worse than it already does in this table.)
- jandrewrogers 1y agoEven within the US, infant mortality rates vary by almost 3x across individual States.
- kbutler 1y agohttps://www.cdc.gov/nchs/pressroom/sosmap/infant_mortality_rates/infant_mortality.htm https://www.cdc.gov/nchs/pressroom/sosmap/infant_mortality_r... I wonder how the consistent gestational period adjustments would affect the statistics for the various states.
- amanaplanacanal 1y agoI've seen it reported recently that both infant and maternal mortality has gone up in states that have outlawed abortion. Even if the doctor forecasts that the pregnancy will be a risk to the mother or infant, they don't want to be second-guessed after the fact and prosecuted for performing the abortion.
- screamingninja 1y agoCan you share the report?
- amanaplanacanal 1y agohttps://thegepi.org/maternal-mortality-abortion-bans/ https://thegepi.org/maternal-mortality-abortion-bans/ and https://jamanetwork.com/journals/jama/article-abstract/2830298 https://jamanetwork.com/journals/jama/article-abstract/28302...
- iamtheworstdev 1y agoit's not just that - but obgyns are leaving states that ban abortions. which has led to entire maternity wards being shut down. https://www.nbcnews.com/health/womens-health/pregnant-women-struggle-find-care-idaho-abortion-ban-rcna117872 https://www.nbcnews.com/health/womens-health/pregnant-women-...
- e40 1y agoCurious that Taiwan is not listed. I understand they have a good healthcare system.
- observationist 1y ago[flagged]
- roughly 1y agoThis is a rock we’re going to have an increasingly hard time throwing at other countries.
- Henchman21 1y agoWhile I agree with you, let’s not let the man babies in charge of the US get away unscathed. They are just as foolishly childish.
- keybored 1y agoChina naturally cares a lot about the classification of the successor government of the other side of a previous civil war. The reason people in other countries care strongly is less clear to me.
- deleted 1y ago[deleted]
- tomhow 1y agoYou can't comment like this on Hacker News. Please read and observe the guidelines, particularly these ones: Be kind. Don't be snarky. Converse curiously; don't cross-examine. Edit out swipes. Comments should get more thoughtful and substantive, not less, as a topic gets more divisive. Please don't fulminate. Please don't sneer... Eschew flamebait. Avoid generic tangents. Omit internet tropes. Please don't use Hacker News for political or ideological battle. It tramples curiosity. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- _DeadFred_ 1y agoThe article's item 3 would have to be backed up for me to take anything away from this. There have traditionally been very different methods for tracking this information, where countries drew lines, etc. When i did medical software (granted long ago) you could not compare data between the USA, France, or Japan in any useful way.
- TacticalCoder 1y ago[dead]
- jonfw 1y agoI think that this study attributes a lot to policy that could be attributed to culture.
- 867-5309 1y ago>the United States, the United Kingdom, and Japan — include all live births >A baby in the UK, France, or the US can be two to three times more likely to die than one in Japan or Finland why do they reference the UK while none of the graphs feature the UK?
- oliwarner 1y agoThis took me a minute too. The opening graph is from the Office for National Statistics. The ONS is a UK govt department. So there is some UK data in the article but this is first-year mortality, not first month. The author does say: > The precise birth data needed to produce these comparable rates is not available for all countries, so only a selection of OECD countries is shown. Perhaps this is the reason. I do agree though, it's mighty strange to have not included an interpretation of you're going to mention them in the text. Perhaps they were excluded after the text was written?
- rwhitman 1y agoJapan, the Nordics, S. Korea and Central Europe, all countries with a demographic crisis. They need those babies.
- rossant 1y agoFrench doctors and the government have expressed concern over the rising mortality rate in recent years. Some worry that a contributing factor may be the relatively low rate of C-sections. Difficult labor is a major risk factor for neonatal death. It is also associated with intracranial hemorrhages at birth, which are common, but even more frequent and severe after complicated deliveries. These hemorrhages are often linked to wrongful diagnoses of shaken baby syndrome, which is commonly assumed whenever an infant presents with intracranial bleeding. France is likely among the countries with the highest rates of such misdiagnoses. Obvious to say the consequences for the child and their parents are severe.
- Maxion 1y agoMeanwhile, in Finland, midwives here are worried abou the increase in C-sections in the last few years. It is most likely a cause of the decrease in funding towards healthcare, causing understaffed maternety wards and a push for c-sections on slow labor.
- otherme123 1y agoWeird that some countries with high C-section rates are not particularly good in mortality (Turkey, Bulgaria, Romania, Poland), while the best countries by mortality has low C-section rates, Norway being the country with the lowest rate in the world. Curiously, France has almost the exact same rate than Finland (200 per 1000 births), which tops the mortality list.
- rossant 1y agoPerhaps a distinction should be made in the data between emergency and planned C-sections.
- deleted 1y ago[deleted]
- jdifjfkfirjfn 1y ago[flagged]
- amai 1y agotldr; "Japan, Sweden, and Finland are at the very bottom. They’re consistently among the best, even when we adjust for reporting inconsistencies. The other Nordic countries — Denmark and Norway — also have very low mortality rates."