The U.S. ranks 51st globally for infant mortality rates. That's on par with Croatia — a country with a GDP a third of the size of the U.S. economy.
The U.S.'s high infant mortality rates can't be chalked up to one factor, instead a plurality of reasons seem to contribute to the disparity, according to group of researchers who explore U.S. infant mortality rates in an economic paper published by the American Economic Journal: Economic Policy.
Here are five other potential reasons that could explain the U.S. infant mortality rate, according to the paper.
1. The U.S. uses a more comprehensive reporting system for infant deaths. Different countries count deaths differently. For example, what constitutes a stillbirth in the U.S. might be different than in other countries. This cannot provide a complete explanation, but it can help explain part of the inflated American infant mortality rates. To help account for reporting differences, the researchers compared micro data from the U.S. with micro data from Finland and Austria, which have comparable reporting systems. They also compared U.S. rates to those of the U.K. and Belgium.
2. Health at birth is a factor, but not the No. 1 driver of infant mortality rates. While this is widely cited as the major driver of poor infant mortality rates in the U.S., the researchers beg to differ. They found that birth weight can explain some differences — for example it explains around 75 percent of the difference between U.S., Finland and Belgium infant mortality rates — but not others. As in the case of Austria and the U.K., birth weight only accounts for 30 percent of the U.S. infant mortality disadvantage.
3. American babies are much more likely to die between the first month and first year of life. While the U.S. has a higher infant mortality rate at all ages, the researchers found the rate accelerates dramatically after the first month of life in the U.S. compared to the other countries in the study.
4. Mortality differences in the U.S. are due largely to socioeconomic differences. When comparing data between countries, the researchers found the infant mortality gap between the U.S.,Finland and Austria widened among lesser educated populations. In other words, babies born to disadvantaged mothers in the U.S. were more likely to die than any other group in the study, even compared to disadvantaged populations in the other countries. "Effectively, either across countries or across regions within the U.S., we see that the observed geographic variation in postneontal [after the first month of life] mortality is heavily driven by variation in health gradients across socioeconomic groups," the authors wrote.
5. Policies prevalent in European countries could also account for differences in mortality rate. The researchers note both Finland and Austria, and much of the rest of Europe, have home nurse visit policies to bring healthcare professionals into babies' homes in their first year of life. These policies help provide checkups, but more importantly can provide information and support for mothers. The researchers note some of these programs exist on a small scale in the U.S. and were expanded somewhat under the Affordable Care Act, but there is still room for them to grow.
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