Infant Mortality: How Does The U.S. Compare With Other Countries?

Infant mortality is one comparative measure of national health, widely used because of the scarcity of other standardized health data in much of the world. In the United States, the infant mortality rate (IMF) has continued to steadily decline over the past several decades, from 26 per 1,000 live births in 1960 to 6.9 per 1,000 live births in 2000, which looks great on the surface. However, when you compare U.S. infant mortality to that of other developed countries, a different picture emerges. While other countries have improved their international standing in infant mortality, the United States has worsened, going from 12th in 1960 to 29th in 2004, according to a new report issued by the Centers for Disease Control and Prevention’s National Center for Health Statistics.
In comparison, the lowest infant death rates were in Singapore, Hong Kong, Japan, Sweden, Norway and Finland, all of which were below 3.5 per 1,000, about half the U.S. rate. There were also 22 countries with infant death rates below 5.0 per 1,000. According to the CDC researchers, while there are some differences in the way countries collect these data; those differences cannot explain the relatively low international ranking of the United States.
The decline has been attributed in part to an increase in preterm births and preterm-related deaths. From 2000 to 2005, the rate of babies born prematurely rose from 11.6 percent to 12.7 percent. And, in 2005, 36.5 percent of infant deaths in the United States were due to preterm-related causes of death, a 5 percent increase since 2000. The impact of preterm-related causes of death was even higher for non-Hispanic black and Puerto Rican women. The rise in preterm births is partially driven by an increase in multiple births resulting from artificial reproductive technologies and in the use of Caesarean delivery or induced labor for mothers with serious medical conditions, according to Dr. Marian F. MacDorman, PhD, one of the study authors.
Disparities that exist among various racial and ethnic groups in the country also have an impact on infant mortality. In 2005, the infant mortality rate among non-Hispanic black Americans was 2.4 times greater than the rate for non-Hispanic white Americans—13.63 per 1,000 live births compared to 5.76 per 1,000. Infant death rates were also higher among Puerto Rican women and American Indian women—8.30 per 1,000 and 8.06 per 1,000 respectively. Cuban women had the lowest rates—4.42 deaths per 1,000 live births—and were the only ethnic group that met the government’s Healthy People 2010 target of fewer than 4.5 infant deaths per 1,000 live births.
The findings are published in the CDC’s October 2008 National Center for Health Statistics data brief, “Recent Trends in Infant Mortality in the United States.” The data come from the Linked Birth/Infant Death Data Set and Preliminary Mortality Data File, collected through the National Vital Statistics System. You can access the full report at www.cdc.gov/nchs.