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U.S. Infant Mortality Rates
What methodological explanations have been offered for the relatively high infant mortality rate in the U.S.
There have been a variety of methodological explanations for the relatively high infant mortality rate in the United States. The most obvious criticism of the conclusion that the U.S. has a higher infant mortality rate than other industrialized nations is that the figures reported by the various countries are not the same. For example, while the World Health Organization (WHO) defines a live birth as any newborn showing signs of life, such as heart beat or a gasp of breath, not all countries follow that definition. The definition of live birth is critical; because the infant mortality rate is the number of all deaths to babies under one-year-old, divided by the number of live births that year. Therefore, the higher the number of live births, the higher the number of total deaths because those babies count in the numbers, and the higher the infant mortality rate. The United States follows WHO's recommendations. In contrast, many of the industrialized nations against which the United States is compared do not follow WHO's recommendations, which drives down their live birth rate and their death rate. Austria and Germany do not count extremely low birth weight infants, Switzerland does not count infants that are less than 12 inches long, and Belgium and France both only count babies that are at least 26 weeks old (Behind the Headlines).
In addition, there are methodological concerns because the birth rates do not compare births among similar groups. For example, the U.S. has a high percentage of people who delay childbearing until they are older, and use fertility treatments to conceive, which results in more multiple pregnancies and higher mortality rates. Furthermore, neonatal care in the United States appears to be comparable to other industrialized nations. Most infants who die in the United States are born critically ill, with 40% of all infant deaths taking place in the first day of life (Behind the Headlines).
2. What social explanations have been given for the infant mortality rate in the U.S.
It is impossible to ignore the social differences in infant mortality rates in the United States. While there may be methodological concerns impacting the U.S. infant mortality rate when compared to other industrialized nations, the reality is that, using the same measures and standards, the infant mortality rate for African-American babies in the United States is almost double the overall American infant mortality rate. "The relatively high rates among black babies reflect poor prenatal care, which is a serious problem for women who lack health insurance. Other factors include social, economic, and health problems affecting young African-American women. For instance, teenage pregnancy and obesity -- which disproportionately strike black women -- are risk factors for having a low weight or premature birth, and babies who are born at low weight or prematurely are precisely the babies at greatest risk of death" (Behind the Headlines). Furthermore, race seems to be a risk factor in and of itself. For example, "even when all other significant risk factors were taken into account, the odds of newborn infants dying were 3.4 times higher in blacks, 1.5 times higher in Latinos, and 1.9 times higher for non-whites in general" (Spence). According to Lester Spence, one of the reasons for this is that the U.S. fails to provide adequate prenatal and preventative health care to mothers and potential mothers, especially in impoverished or minority communities. He believes this is because the U.S. "government has been far more concerned with moral pronouncements regarding procreation than it has been with the reasonable policies needed in order to ensure the protection of mothers" (Spence).
3. Explain the issue from each of the sociological theories outlined in the chapter.
Market-oriented theories assume that the best possible economic consequences come as the result of individual freedom and a free market. In other words, market-oriented theories are based on the supremacy of unrestricted capitalism. According to market-oriented theory, government bureaucracy should not dictate the cost or availability of goods. Therefore, the fact that impoverished people cannot afford adequate prenatal care, resulting in disparity in infant mortality rates between classes and between races, while lamentable, is not something that should prompt government interference. In fact, a pure market-oriented theorist may go so far as to suggest that higher infant mortality rates among lower-income groups…[continue]
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