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Thread: US has the worst rate of maternal deaths in the developed world

  1. #21
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    Quote Originally Posted by Tennyson View Post
    The U.S.’s maternal deaths cannot be compared to other countries. The criteria are not the same between countries and the heterogeneity of the U.S. vis-ŗ-vis other countries is not taken into consideration.

    The criteria:

    The U.S. defines maternal deaths from the start of pregnancy until one year after the end of the pregnancy. The calculation that the U.S.’s maternal deaths are compared to internationally is WHO’s definition of maternal death:

    Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. To facilitate the identification of maternal deaths in circumstances in which cause of death attribution is inadequate, a new category has been introduced: Pregnancy-related death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death.

    There is no calculation or filter in the WHO, UNICEF, UNFPA, World Bank Group, or the United Population Division Maternal Mortality Estimation Inter-Agency Group’s calculations from 1990 to their latest data of 2015.

    The heterogeneity:

    What is not taken into consideration is the lifestyle and behavior that are extraneous to medicine: American women are becoming pregnant much later in life coupled with the highest rate of obesity in the world, high diabetes rates, high blood pressure, etc. than other countries.
    Poor access to healthcare is associated with higher obesity, diabetes, and blood pressure, for obvious reasons.

    Here, a simple thought experiment. A lower-class American and a lower-class Swede each has an accident that tears up his respective knee pretty badly. Each goes to the doctor and finds out that repairing it properly will require surgery and a program of rehab. The Swede has access to high-quality socialized medicine, so he books the appointment, gets the surgery, goes through the rehab, and is soon up and running again (literally). The American doesn't have insurance and can't find the thousands of dollars it would take to cover it out-of-pocket. So, he just tries to gut it out, progressively tearing his knee up worse, while trying to deal with the pain by way of chronic reliance on opiates. He avoids walking when he can, and as a result becomes insulin insensitive and starts to put on weight. The weight puts even more pressure on his knee, making it even worse. He favors the other knee so heavily and his girth puts so much strain on his body that he ends up with arthritis in the other knee and a bad back, too. Eventually he can't even work and winds up on disability, and can only get around with a cane or one of those scooters. He gets even worse, with morbid obesity, high blood pressure, and diabetes, while his Swedish counterpart is living a strong and healthy life.

    All the while, right-wingers are blaming him for being fat and lazy, as if it were some bizarre coincidence, rather than a result of specific policies, that the fat and sedentary people were disproportionately in the US (and, even within the US, disproportionately in the areas with conservative public policy).
    Thanks from labrea, Claudius the God and Friday13

  2. #22
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    Quote Originally Posted by Tennyson View Post
    US infant mortality rates cannot be compared to other countries either.

    The US is the only country that uses the full WHO definition of live birth and other countries eliminate several of the criteria. Switzerland uses only two of the four criteria. Italy uses only three of four criteria, etc. This allows other countries to use weight, gestation period, and length to classify a baby as not being born alive, and the US counts all as a live births. Other countries do not count premature births as live births if they die afterwards. The U.S. counts them as live births. The U.S. does more for premature infants than most countries, which also skews the numbers when they do not survive. When factoring in all the criteria, the US has one of the lowest infant mortality rates in the world.

    The data regarding Infant mortality rates in the US compared to the rest of the world come from the CDC, and the CDC gets their information from the OECD and the United States Children’s Fund. The data is brutally skewered and misleading.

    There is no standard or continuity regarding the registration of babies born too early, too light, and too short in the other countries.

    There is no standard or continuity regarding the registration, or preventing selective registration, of pre-term infants who survived in other countries.

    There is no standard or continuity regarding the systematic under-registration of infants who did not survive in other countries.

    There is little to no data from the cultures that do not attempt to save prematurely born infants with birth defects. The US always does its best to save any baby born regardless of its condition, and those that do not survive are added to the misleading statistic used by the OECD.

    When infants born before 24 weeks are subtracted from the CDC report, the mortality rate decreases by 30%. This accurate data puts the US equal or lower than any other developed country.

    Many countries do not consider an infant that dies at birth weighing less than 500 grams as a live birth. The US considers an infant that weighs less than 500 grams and dies at birth a live birth. Eighty percent of these births in other countries do not survive and are not counted, but are counted in the US.

    Many countries classify a baby as stillborn or as a miscarriage if it survives less than 24 hours regardless if it is breathing and has a beating heart. The US classifies these infants as live born. Forty percent of all infant deaths happen within twenty-four hours.

    If a child in Hong Kong or Japan is born alive but dies within the first 24 hours of birth, he or she is reported as a miscarriage and does not affect the country's reported infant mortality rates.

    In Switzerland and other parts of Europe, a baby born who is less than 30 centimeters long is not counted as a live birth. The U.S. counts these infants as live births.
    The article was about maternal deaths, not infants.

    If we were a great country among our peers, we wouldn't have to make excuses to explain our crappy outcomes.

  3. #23
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    Quote Originally Posted by Arkady View Post
    Poor access to healthcare is associated with higher obesity, diabetes, and blood pressure, for obvious reasons.

    Here, a simple thought experiment. A lower-class American and a lower-class Swede each has an accident that tears up his respective knee pretty badly. Each goes to the doctor and finds out that repairing it properly will require surgery and a program of rehab. The Swede has access to high-quality socialized medicine, so he books the appointment, gets the surgery, goes through the rehab, and is soon up and running again (literally). The American doesn't have insurance and can't find the thousands of dollars it would take to cover it out-of-pocket. So, he just tries to gut it out, progressively tearing his knee up worse, while trying to deal with the pain by way of chronic reliance on opiates. He avoids walking when he can, and as a result becomes insulin insensitive and starts to put on weight. The weight puts even more pressure on his knee, making it even worse. He favors the other knee so heavily and his girth puts so much strain on his body that he ends up with arthritis in the other knee and a bad back, too. Eventually he can't even work and winds up on disability, and can only get around with a cane or one of those scooters. He gets even worse, with morbid obesity, high blood pressure, and diabetes, while his Swedish counterpart is living a strong and healthy life.

    All the while, right-wingers are blaming him for being fat and lazy, as if it were some bizarre coincidence, rather than a result of specific policies, that the fat and sedentary people were disproportionately in the US (and, even within the US, disproportionately in the areas with conservative public policy).
    Obesity is a personal choice. Access to healthcare is irrelevant to eating Big Macs, drinking Coke, and sitting on the couch.

  4. #24
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    Quote Originally Posted by labrea View Post
    The article was about maternal deaths, not infants.

    If we were a great country among our peers, we wouldn't have to make excuses to explain our crappy outcomes.
    My reply is to an infant mortality post.
    Thanks from pragmatic

  5. #25
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    Quote Originally Posted by Tennyson View Post
    My reply is to an infant mortality post.
    Another poster who did not read the entire post he was responding to.

  6. #26
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    Quote Originally Posted by Tennyson View Post
    US infant mortality rates cannot be compared to other countries either.

    The US is the only country that uses the full WHO definition of live birth and other countries eliminate several of the criteria. Switzerland uses only two of the four criteria. Italy uses only three of four criteria, etc. This allows other countries to use weight, gestation period, and length to classify a baby as not being born alive, and the US counts all as a live births. Other countries do not count premature births as live births if they die afterwards. The U.S. counts them as live births. The U.S. does more for premature infants than most countries, which also skews the numbers when they do not survive. When factoring in all the criteria, the US has one of the lowest infant mortality rates in the world.

    The data regarding Infant mortality rates in the US compared to the rest of the world come from the CDC, and the CDC gets their information from the OECD and the United States Children’s Fund. The data is brutally skewered and misleading.

    There is no standard or continuity regarding the registration of babies born too early, too light, and too short in the other countries.

    There is no standard or continuity regarding the registration, or preventing selective registration, of pre-term infants who survived in other countries.

    There is no standard or continuity regarding the systematic under-registration of infants who did not survive in other countries.

    There is little to no data from the cultures that do not attempt to save prematurely born infants with birth defects. The US always does its best to save any baby born regardless of its condition, and those that do not survive are added to the misleading statistic used by the OECD.

    When infants born before 24 weeks are subtracted from the CDC report, the mortality rate decreases by 30%. This accurate data puts the US equal or lower than any other developed country.

    Many countries do not consider an infant that dies at birth weighing less than 500 grams as a live birth. The US considers an infant that weighs less than 500 grams and dies at birth a live birth. Eighty percent of these births in other countries do not survive and are not counted, but are counted in the US.

    Many countries classify a baby as stillborn or as a miscarriage if it survives less than 24 hours regardless if it is breathing and has a beating heart. The US classifies these infants as live born. Forty percent of all infant deaths happen within twenty-four hours.

    If a child in Hong Kong or Japan is born alive but dies within the first 24 hours of birth, he or she is reported as a miscarriage and does not affect the country's reported infant mortality rates.

    In Switzerland and other parts of Europe, a baby born who is less than 30 centimeters long is not counted as a live birth. The U.S. counts these infants as live births.
    Yes, I'm aware of the conservative song and dance. I've heard it again and again. That was the first thing I posted about in this thread.

    Tell the conservatives that maternal mortality is high here, and they'll insist that maternal mortality can't be compared, but that the babies are doing well. Show them that the babies are, in fact, not doing well, and they'll insist you can't compare infant mortality, due to unsubstantiated assertions about how stillborn babies or preemies get counted (these right-wing assertions are pretty much always paraphrased from some right-wing propaganda site, rather than backed up by actual evidence). If I address this now by pointing out that children age 1-to-5 die in the US at rates equally or even more elevated relative to kids in the same age group in other developed countries, as is true, you'll surely have some reason those stats don't count, either. And if I show mortality is higher for Americans age 5-to-10, to an even greater proportional extent, you'll go hunting for some right-wing site to tell you why you're at liberty to ignore that, as well. We could go right on up the mortality rates, for teens, twenties, and so on. I've been through this before. For every age range, there was some half-clever, wholly-unsubstantiated assertion for why that elevated mortality was a statistical illusion or had nothing to do with healthcare (e.g., American teens just die more because they drive more).

    That's how debates work when one side starts with an unshakable quasi-religious faith in its conclusions. It doesn't matter how many pieces of evidence show they're wrong. They'll just bend their efforts to coming up with a reason the evidence can be ignored, then they'll return to their evidence-free beliefs.

    So yes, I get it: maternal mortality, infant mortality, and every other category of mortality can't be compared -- not for any reason you cited, but because comparing them would suggest something you're not comfortable with.

  7. #27
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    Quote Originally Posted by Tennyson View Post
    Obesity is a personal choice. Access to healthcare is irrelevant to eating Big Macs, drinking Coke, and sitting on the couch.
    Free market theory says people choose well when they have perfect information. In some low income areas, people don't even have access to fresh fruit and vegetables, or safe places to get some exercise.

  8. #28
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    Quote Originally Posted by Tennyson View Post
    Obesity is a personal choice. Access to healthcare is irrelevant to eating Big Macs, drinking Coke, and sitting on the couch.
    Why do you suppose people "choose" to be obese so much more often in the US than in, say, Sweden? Why do people choose to be obese so much more in Mississippi than in Massachusetts? Why do they choose to be obese so much more in rural counties than urban ones? Why so many bad choices in the South, the sticks, etc.?

    When it's one person, analyzing it as nothing but a personal choice might make sense. But when trends are playing out across populations numbering in the millions, it's a cop-out. "Bad choices" on that scale are the result of bad choices at the policy level, not just the individual level.
    Thanks from labrea and Friday13

  9. #29
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    Quote Originally Posted by Arkady View Post
    Yes, I'm aware of the conservative song and dance. I've heard it again and again. That was the first thing I posted about in this thread.

    Tell the conservatives that maternal mortality is high here, and they'll insist that maternal mortality can't be compared, but that the babies are doing well. Show them that the babies are, in fact, not doing well, and they'll insist you can't compare infant mortality, due to unsubstantiated assertions about how stillborn babies or preemies get counted (these right-wing assertions are pretty much always paraphrased from some right-wing propaganda site, rather than backed up by actual evidence). If I address this now by pointing out that children age 1-to-5 die in the US at rates equally or even more elevated relative to kids in the same age group in other developed countries, as is true, you'll surely have some reason those stats don't count, either. And if I show mortality is higher for Americans age 5-to-10, to an even greater proportional extent, you'll go hunting for some right-wing site to tell you why you're at liberty to ignore that, as well. We could go right on up the mortality rates, for teens, twenties, and so on. I've been through this before. For every age range, there was some half-clever, wholly-unsubstantiated assertion for why that elevated mortality was a statistical illusion or had nothing to do with healthcare (e.g., American teens just die more because they drive more).

    That's how debates work when one side starts with an unshakable quasi-religious faith in its conclusions. It doesn't matter how many pieces of evidence show they're wrong. They'll just bend their efforts to coming up with a reason the evidence can be ignored, then they'll return to their evidence-free beliefs.

    So yes, I get it: maternal mortality, infant mortality, and every other category of mortality can't be compared -- not for any reason you cited, but because comparing them would suggest something you're not comfortable with.
    You are welcome to make a comparison between countries using the same criteria and account for the heterogeneity difference. The Gates Foundation tried and spent a lot of money, and conceded failure because it cannot be done.

  10. #30
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    Quote Originally Posted by Arkady View Post
    Why do you suppose people "choose" to be obese so much more often in the US than in, say, Sweden? Why do people choose to be obese so much more in Mississippi than in Massachusetts? Why do they choose to be obese so much more in rural counties than urban ones? Why so many bad choices in the South, the sticks, etc.?

    When it's one person, analyzing it as nothing but a personal choice might make sense. But when trends are playing out across populations numbering in the millions, it's a cop-out. "Bad choices" on that scale are the result of bad choices at the policy level, not just the individual level.
    Laziness and the lifestyle of their choice.

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