CDC Reports That U.S. Infant Mortality Declines by 2% in 2006, But Rates Remain Higher Than in Other Industrialized Nations Despite Higher Spending on Health Care in the U.S.

The rate of infant deaths in the U.S. decreased by 2% in 2006 but remains higher than that of most other industrialized countries, suggesting that Americans pay more for medical services than other nations but receive lower quality care, according to CDC data, the New York Times reports (Harris, New York Times, 10/16). The results were compiled through a review of about 95% of U.S. birth records (Lauerman, Bloomberg, 10/15). In 2006, 6.71 infants died for every 1,000 live births, a slight drop from the rate of 6.89 reported in 2000 and 6.86 in 2005. Twenty-two countries had infant death rates in 2004 that were below five per 1,000 live births (New York Times, 10/16).

The U.S ranked 12th in the world in infant mortality in 1960, but fell to 23rd in 1990, 27th in 2000 and 29th in 2004 (CQ HealthBeat, 10/15). According to the Times, more than 28,000 children younger than age one die annually in the U.S. (New York Times, 10/16). "The plateau we have had is of great concern," Marian MacDorman, a senior statistician and author of the report, said. She added, "Even if it is declining again, as the research suggests, we missed out on some gains during the plateau, and other indicators associated with infant mortality are going in the wrong direction" (Bloomberg, 10/15). Grace-Marie Turner, president of the Galen Institute, said, "Infant mortality rates and our comparison with the rest of the world continue to be an embarrassment to the United States."

Researchers attribute the U.S. rate to the rise in preterm births, which account for two-thirds of infant deaths. The rate of preterm births rose from 9% in 2000 to 12.7% in 2005. The most rapid rise reported was among babies born at 34 to 36 weeks of gestation, about 92% of whom were birthed by caesarean section, according to a recent study. However, a growing portion of these late preterm births could be for reasons of convenience, according to Alan Fleischman, medical director of the March of Dimes Foundation. He said, "Women have always been concerned about the last few weeks of pregnancy as being onerous," adding, "what we hadn't realized before is that the risks to the babies of early induction are quite substantial."

Some economists say the nation's inability to improve its rate shows that the U.S. health care system is failing, despite spending more than other countries. Karen Davis, president of the Commonwealth Fund, said, "We're spending twice what other countries do, and we're falling further and further behind them in important measures like infant mortality." However, Turner said many of the deaths can be attributed to socioeconomic factors -- such as obesity, the prevalence of substance use, gun violence and automobile accidents -- that health reform would not address (New York Times, 10/16).

Minorities
Blacks had the highest rate of infant deaths in 2005, at 13.63 deaths per 1,000 live births. Rates for Puerto Ricans and American Indians were above eight deaths per 1,000 live births. Cubans, with a rate of 4.42 deaths per 1,000 live births, were the only ethnic group with rates below HHS' U.S. Health People 2010 goal of less than 4.5 deaths per 1,000 live births. Whites had a rate of 5.75 deaths per 1,000 live births (Bloomberg, 10/15).

The report is available online.

NBC's "Nightly News" on Wednesday reported on the 2006 infant mortality rate (Williams, "Nightly News," NBC, 10/15).