The United States ranks first in the global community in lots of ways. Unfortunately, most of our first-place trophies are more than a little troublesome.
From jailed people per capita to ignorance, we have a pretty bleak list of wins. And a new report finds that we have yet another concerning trophy to tout: infant death rates.
American Vs. European Death Rates
According to a new working paper from the NBER, America has a death problem across the board. At every age, race, and income level, Americans have a higher mortality risk.
The average life expectancy of almost every western European country is over 80 years old. Monaco has the longest life expectancy of roughly 86 years. (And to be fair, I wouldn’t want to die if I lived in Monaco, either.)
However, U.S. life expectancy has never exceeded 79—ever. American babies are more likely to die before they turn five. Teens are more likely to die before the age of 20. Adults are more likely to die before 65.
Europe’s mortality rates in rich and poor communities are very similar. Researchers attribute this to “health improvements disseminated within European countries in a way that includes even the poorest areas.”
Meanwhile, the U.S. has the highest poverty and inequality of any country in the OECD. And unlike Europe, this greatly affects how long you’ll live.
American infants are far more likely to die in poor counties. Black teenagers in the poorest U.S. counties are twice as likely to die before they turn 20.
But again, it’s not just poor Americans. White Americans living in rich counties still die earlier than Europeans. When compared to Black Americans, the gap is even greater.
“It says something negative about the overall health system of the U.S. that even after we grouped counties by poverty and looked at the richest 10th percentile, we still saw this longevity gap,” the paper’s author told The Atlantic.
Why Is America So Good At Dying?
Inequality and inefficient healthcare systems are major contributors to IMR. Still, they aren’t the only factors involved.
A 2016 study in the AJM found that Americans are ten times more likely to be killed by a gun than in other developed countries. Gun homicide rates are 25 times higher in the U.S. and gun suicide is eight times higher.
Moreover, we reached a heartbreaking milestone in 2018. That year, gun violence became the leading cause of death for all children and teens ages one to 19. This was the first time in history that gun violence surpassed motor vehicle accidents.
Motor vehicle accidents still play a role in infant mortality rates. In 2019, over 600 kids ages 12 and younger died in car crashes. 38% were not buckled into their seat.
This statistic is a little difficult to compare to other countries, though. America has one of the highest rates of miles driven per capita. We’re on the road more, so car crashes are more likely.
Generally speaking, socioeconomics seems to be the main factor in IMR. Non-Hispanic Black and Native babies are twice as likely to die than white infants.
IMRs are also the highest in the South. Mississippi has the highest rate of 8.9 deaths per 1,000 live births. It is also the poorest state, according to the U.S. Census Bureau.
Abortion’s Role In Infant Death Rates
The study found that infants in states with no abortion bans are less likely to die than those in states with abortion bans. Yep, you read that right. States with ready abortion access have lower IMR.
Abortion bans increase IMR in several ways. One, these bans undermine medical counsel. Second, forced pregnancies increase psychological distress. This is a known risk factor for poor birth outcomes.
These policies can also increase the risk of postpartum depression. Studies have found PPD to be a risk factor for sudden infant death or SIDS.
Finally, abortion bans force individuals to have babies regardless of whether they have the resources and income to provide for them.
This study is proof that “pro-life” does not always mean “anti-abortion.”
The Y2K Surge
America hasn’t always had a death problem, though. The Atlantic reports that in the three decades before COVID-19, the Black American lifespan surged.
The Black-white lifespan gap narrowed in rich and poor areas and across all ages. The gap was split nearly in half—from seven to 3.6 years.
“This is a really important story that we ought to move to the forefront of the public debate,” Schwandt, the NBER paper’s co-author, told The Atlantic. “What happened here? And how do we continue this improvement and learn from it?”
Lifespans were longer in the late ‘90s, and researchers wanted to find out why. They found that better cardiovascular disease and cancer treatments played a major role. New drugs and therapies for high cholesterol, blood pressure, and cancers also helped.
U.S. policy also helped contribute to longer lifespans. Schwandt credits Medicaid expansion, earned-income tax credits, and air pollution reduction.
Schwandt says we should focus on these ’90s stats, not the grim stats of today. “To improve the health and well-being of our populations, we have to give attention to positive achievements so that we can learn from them,” said Schwandt.
What Does This Mean For American Babies?
Experts believe the answer to lowering IMR lies in U.S. policy. Namely, they believe increasing life expectancy starts with closing socioeconomic gaps.
A 2016 study suggests in-home nurse visits, a policy practiced in most western European countries. “These visits combine well-baby checkups with caregiver advice and support,” the study reads.
“These policies don’t focus on alleviating resource constraints per se. Rather, they focus on providing support targeted to mothers and infants,” the study continues.
The NIH is also looking into methods of preventing birth defects and preterm births. Additionally, it suggests creating safer sleep environments to prevent SIDS and using newborn screenings to detect hidden conditions.
The NICHQ performed a case study using the above policy changes. Additionally, they included smoking cessation and pre- and interconception care. 81% of states showed a decline in IMR.
Lastly, giving women access to medical care will help decrease IMR. Abortion bans don’t prevent abortions. And as these studies suggest, the bans don’t always save the lives pro-lifers claim to protect.
In conclusion, making society more equitable is our best chance to reduce the rising IMR. This is a national problem. Solving it is going to take a national effort.