CHICAGO – America may be the world's superpower, but its survival rate for newborn babies ranks near the bottom among modern nations, better only than Latvia.
Among 33 industrialized nations, the United States is tied with Hungary, Malta, Poland and Slovakia with a death rate of nearly 5 per 1,000 babies, according to a new report. Latvia's rate is 6 per 1,000.
"We are the wealthiest country in the world, but there are still pockets of our population who are not getting the health care they need," said Mary Beth Powers, a reproductive health adviser for the U.S.-based Save the Children, which compiled the rankings based on health data from countries and agencies worldwide.
The U.S. ranking is driven partly by racial and income health care disparities. Among U.S. blacks, there are 9 deaths per 1,000 live births, closer to rates in developing nations than to those in the industrialized world.
"Every time I see these kinds of statistics, I'm always amazed to see where the United States is because we are a country that prides itself on having such advanced medical care and developing new technology ... and new approaches to treating illness. But at the same time not everybody has access to those new technologies," said Dr. Mark Schuster, a Rand Co. researcher and pediatrician with the University of California, Los Angeles.
The Save the Children report, released Monday, comes just a week after publication of another report humbling to the American health care system. That study showed that white, middle-aged Americans are far less healthy than their peers in England, despite U.S. health care spending that is double that in England.
In the analysis of global infant mortality, Japan had the lowest newborn death rate, 1.8 per 1,000 and four countries tied for second place with 2 per 1,000 — the Czech Republic, Finland, Iceland and Norway.
Still, it's the impoverished nations that feel the full brunt of infant mortality, since they account for 99 percent of the 4 million annual deaths of babies in their first month. Only about 16,000 of those are in the United States, according to Save the Children.
The highest rates globally were in Africa and South Asia. With a newborn death rate of 65 out of 1,000 live births, Liberia ranked the worst.
In the United States, researchers noted that the population is more racially and economically diverse than many other industrialized countries, making it more challenging to provide culturally appropriate health care.
About half a million U.S. babies are born prematurely each year, data show. African-American babies are twice as likely as white infants to be premature, to have a low birth weight, and to die at birth, according to Save the Children.
The researchers also said lack of national health insurance and short maternity leaves likely contribute to the poor U.S. rankings. Those factors can lead to poor health care before and during pregnancy, increasing risks for premature births and low birth weight, which are the leading causes of newborn death in industrialized countries. Infections are the main culprit in developing nations, the report said.
Other possible factors in the U.S. include teen pregnancies and obesity rates, which both disproportionately affect African-American women and also increase risk for premature births and low birth weights.
In past reports by Save the Children — released ahead of Mother's Day — U.S. mothers' well-being has consistently ranked far ahead of those in developing countries but poorly among industrialized nations. This year the United States tied for last place with the United Kingdom on indicators including mortality risks and contraception use.
While the gaps for infants and mothers contrast sharply with the nation's image as a world leader, Emory University health policy expert Kenneth Thorpe said the numbers are not surprising.
"Our health care system focuses on providing high-tech services for complicated cases. We do this very well," Thorpe said. "What we do not do is provide basic primary and preventive health care services. We do not pay for these services, and do not have a delivery system that is designed to provide either primary prevention, or adequately treat patients with chronic diseases."