Transcript The United States and Child Mortality

The United States and
Child Mortality
Progress toward Millennium
Development Goal #4
Millennium Development
Goal #4: Reduce Child
Mortality

Child mortality is a statistic that
describes the number of children that
die before they are five years old.
– Rate per thousand
Millennium Development
Goal #4:


In developing countries, one child in
10 dies before its fifth birthday,
compared with 1 in 143 in highincome countries.
Mortality rates for children under five
dropped by 15 percent since 1990, but
the rates remain high in developing
countries. (UN, 2005)
MDG #4: Target

Reduce the child mortality of children
under five by two-thirds by 2015
Causes of Child Mortality






Poverty
War and civil unrest
Diseases: HIV/AIDS, malnutrition,
malaria, diarrhea, and acute
respiratory infections
Low birth weights
Poor health care during pregnancy
Adolescent pregnancy
Source: The World Health Report, 2005, http://www.who.int/whr/2005/en/index.html
Child Mortality and the
U.S.: Statistics



U.S. Population: 291,038,000
GDP per capita: $35,182
Annual number of under-5 deaths per
thousand (2003): 34
Child mortality rates (per thousand) :
1

2
– Male: 9
– Female: 7
1. Source: UNICEF, http://www.unicef.org/infobycountry/usa.html
2. Source: World Health Organization, http://www.who.int/countries/usa/en,
2004 data
U.S. Statistics


Total health expenditures per capita :
$4,887
Total health expenditures as a
percentage of GDP : 13.9%
1
2
1. Source: World Health Organization, http://www.who.int/countries/usa/en/
Is Child Mortality a problem
in the United States?



Not in comparison with the rest of the
world
50% of all child deaths are
concentrated in China, the Democratic
Republic of the Congo, Ethiopia, India,
Nigeria and Pakistan.
But…
Child Mortality in the
U.S.: A Closer Look


The child mortality rate in the U.S. is
almost double the rate1 in Hong Kong
(3.1) and Japan (3.4)
The child mortality rate (also called
the Infant Mortality rate) in the United
States varies among racial/ethnic
groups
2
1. National Center for Health Statistics (NCHS) at the Centers for Disease Control and
Prevention, 1999 data
2.Source: Gale Encyclopedia of Medicine, Jan 1, 2001. Minority health. M.D. Laith
Farid Gulli; M.S. Nicole Mallory. Retrieved from Infotrac.
Child Mortality in the
U.S.: A Closer Look


African Americans: 14.2 per 1,000 live
births in 1996 (approximately 2.5
times higher than Caucasians)
Hispanics: 7.6 per 1,000 live births
– Puerto Ricans: 8.9 per 1,000 live births
Source: Gale Encyclopedia of Medicine, Jan 1, 2001. Minority health. M.D.
Laith Farid Gulli; M.S. Nicole Mallory. Retrieved from Infotrac.
Child Mortality in the
U.S.: A Closer Look


Despite higher poverty and lower
education rates, Hispanic infants have
higher birthweights and their child
mortality rates approximate those of
white infants.
Cultural practices, family support,
selective migration, diet, and genetic
heritage are possible contributing
factors.
Child Mortality in the
U.S.: A Closer Look

Very low birth weight accounts for
approximately two thirds of the blackwhite gap in infant mortality,
specifically preterm deliveries.
Child Mortality in the U.S.: A
Historical Perspective

“Follow up question:” To what extent
has the status of women advanced
throughout the 20th century?
Child Mortality in the U.S.: A
Historical Perspective


The U.S. child mortality rates
declined by 90% in the 20th century
The highest child mortality rates
have always been in U.S. cities
Child Mortality in the U.S.: A
Historical Perspective


Racial differences in child mortality have
not been explained fully by differences in
socioeconomic status.
Black infants born to college-educated
parents have higher child mortality rates
than white infants born to parents of
similar educational background; this
difference is attributed to a higher rate of
very low birthweight
Child Mortality in the U.S.: A
Historical Perspective

A complex interaction of social,
environmental, and biologic factors
experienced uniquely by black
women might account for the
difference in child mortality rates.
Comparing Child Mortality
Statistics
Comparing Child Mortality in the
U.S. to other countries in the
Americas
(Follow up question:
To what extent have
economic disparities between developed and
developing nations persisted or increased? )
Comparing Regions of the
World
200
180
160
140
120
100
80
60
40
20
0
Northern Africa
Sub-Saharan Africa
Southern Asia
CIS
Developed regions
1990
2002
Source: http://millenniumindicators.un.org/unsd/mi/mi_worldregn.asp#Annex
What Progress is Being
Made?

UN Millennium Development Goals
Progress Reprot 2004:
– http://www.un.org/millenniumgoals/mdg
2004chart.pdf
What Needs to be Done?



Access to reproductive health care needs to
be expanded.
Distribute vitamin supplements in countries
without functioning health care systems.
Access to clean water and sanitation is
needed to further reduce occurrences of
diarrhea.
Source: http://cyberschoolbus.un.org/mdgs/index.html
What Needs to be Done?


Distribute insecticide-treated nets to
families in area at high risk for malaria
and make sure the nets are retreated
each year.
Increase the number of health care
providers in underserved populations,
particularly in rural areas.
Source: http://cyberschoolbus.un.org/mdgs/index.html
References



Gale Encyclopedia of Medicine, Jan 1, 2001. Minority health.
M.D. Laith Farid Gulli; M.S. Nicole Mallory. Retrieved from Infotrac
5/15/05.
National Center for Health Statistics (NCHS) at the Centers for
Disease Control and Prevention, 1999. Retrieved from Harvard Public
Health Now,
http://www.hsph.harvard.edu/now/dec10/apha_infant.html, 5/16/05.
United Nations
– http://www.un.org/millenniumgoals/ retrieved 5/15/05.
– http://cyberschoolbus.un.org/mdgs/index.html retrieved 5/15/05.
– http://millenniumindicators.un.org/unsd/mi/mi_worldregn.asp#Annex
retrieved 5/15/05.
– http://www.unicef.org/ retrieved 5/15/05.

World Health Organization
– http://www.who.int/countries/usa/en retrieved 5/15/05.