Infant mortality rate, United States, 2000-2007
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Transcript of Infant mortality rate, United States, 2000-2007
Behind International Rankings of Infant Mortality: How the United
States Compares with Europe
Marian MacDorman and T.J. MathewsDivision of Vital Statistics
National Center for Health Statistics
Acknowledgements: Sam Notzon and Jennifer Madans, NCHS
International Health Rankings: A Look Behind the Numbers National Conference on Health Statistics
August 16-18, 2010
Infant mortality rate, United States, 2000-2007
2000 2001 2002 2003 2004 2005 2006 20070
1
2
3
4
5
6
7
86.89 6.84 6.95 6.84 6.78 6.86 6.68
6.75
Rat
e pe
r 1,
000
live
birt
hs
Source: 2000-2006 data are from the linked birth/infant death data sets. 2007 data are from the main mortality file.
Infant mortality rates, selected countries, 2005
SlovakiaUnited States
PolandNorthern Ireland
Cuba HungaryCanada
ScotlandNew Zealand
AustraliaEngland and Wales
NetherlandsItaly
IsraelDenmark
AustriaSwitzerland
SpainIreland
GermanyGreece
BelgiumFrance
PortugalCzech Republic
NorwayFinland
JapanHong Kong
SwedenSingapore
0 1 2 3 4 5 6 7
7.26.9
6.46.3
6.26.2
5.45.2
5.15.05.0
4.94.7
4.64.4
4.24.2
4.14.0
3.93.8
3.73.6
3.53.4
3.13.0
2.82.42.4
2.1
Rate per 1,000 live birthsSource: Health, United States, 2008
Infant mortality rates excluding births at <22 weeks of gestation, US and selected European countries, 2004
SlovakiaPoland
HungaryUnited States
ScotlandEngland and Wales
NetherlandsIreland
DenmarkGermany
AustriaSpain
Northern IrelandItaly
GreecePortugal
FranceCzech Republic
FinlandSwedenNorway
0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0
7.0
6.8
6.6
5.8
4.9
4.9
4.6
4.6
4.4
4.1
4.1
4.0
4.0
4.0
4.0
3.9
3.9
3.7
3.4
3.0
3.0
Rate per 1,000 live births
Source: NCHS linked birth/infant death data set (for US data), and European Perinatal Health Report (for European data).
Infant mortality can be partitioned into two key components:
1. Gestational age-specific infant mortality rates (i.e. the mortality rate for infants at a given gestational age).
2. Distribution of births by gestational age.
Percentage of preterm births, United States and selected European countries, 2004
United StatesAustria
GermanyHungary
SpainScotland
England and WalesNetherlands
NorwayCzech Republic
DenmarkItaly
PolandPortugal
Northern IrelandFrance
SlovakiaSwedenGreeceFinlandIreland
0 2 4 6 8 10 12 1412.4
11.48.9
8.68.0
7.67.57.4
7.17.06.96.86.86.8
6.66.36.36.3
6.05.65.5
Note: Excludes births at <22 weeks of gestation to promote comparability between countries. Preterm births are those from 22 to 36 weeks of gestation. Source: NCHS linked birth/infant death data set (for US data), and European Perinatal Health Report (for European data).
Infant mortality rate for the US and Sweden, and the US infant mortality rate standardized for
Sweden’s gestational age distribution, 2004
Sweden IMR US IMR US IMR if the US had Sweden's
gestational age distribution
0
1
2
3
4
5
6
7
3.0
5.8
3.9
Infa
nt m
orta
lity
rate
33% lower
Note: Excludes births at <22 weeks of gestation
Conclusions• In 2005, the United States ranked 30th in the world in infant
mortality.
• Some differences exist in reporting of very small infants.
• These reporting differences are not the primary explanation for the United States’ relatively low international ranking.
• In 2005, 22 countries had infant mortality rates of 5.0 or below.
• One would have to assume that these countries did not report more than 1/3 of their infant deaths for their infant mortality rates to equal or exceed the US rate.
• This level of underreporting appears unlikely for most developed countries.
Conclusions (cont.)
• Infant mortality rates for preterm infants are lower and rates for full-term infants are higher in the US than in Europe.
• In 2004, 1 in 8 US infants were born preterm compared to 1 in 16 in France and Sweden and 1 in 18 in Ireland and Finland.
• If the United States had Sweden’s distribution of births by gestational age, nearly 8,000 infant deaths in the US would be averted each year, and the US infant mortality rate would be 1/3 lower.
• The main cause of the US’ high infant mortality rate when compared to Europe is the very high percentage of preterm births in the US, the period when infant mortality is greatest.
http://www.cdc.gov/nchs/data/databriefs/db23.pdf
Full report available at:
Questions?
Marian [email protected]