Poverty and inequality not the only cause of child death, of course. But they are leading factors.
A new report concludes 600,000 children have died in the United States for no reason over a 50-year period. Thousands more will die this year, and next year, and the year after that. 600,000 is a lot of people. It’s more than the population of Tulsa, Oklahoma. Or Oakland, California. Or Minneapolis, Minnesota. Or Omaha, Miami, Atlanta, and Milwaukee. An entire city of children has been lost.
These deaths should have led every news broadcast and been a banner headline in every newspaper in the country. They would have been, if terrorists had killed these kids. But after the deaths of 600,000 children, nothing’s changed at all.
The journal Health Affairs, compared child mortality in the United States with that of 19 other comparably developed nations. Here’s what the authors found:
A child born in the U.S. is 76 percent more likely to die before reaching adulthood than a child born elsewhere in the developed world.
“From 2001 to 2010 the risk of death in the U.S. was 76 percent greater for infants and 57 percent greater for children ages 1–19.”
“During this decade, children ages 15–19 were eighty-two times more likely to die from gun homicide in the U.S. Over the fifty-year study period, the lagging U.S. performance amounted to over 600,000 excess deaths.”
“There is not a single category for which the comparison countries had higher mortality rates than the U.S. over the last three decades of our analysis.” The U.S., say the report’s authors, is “the most dangerous of wealthy nations for a child to be born into.”
The United States spends more on health care than the other countries, but has worse outcomes. Although it spent more on health care, the U.S. “spent significantly less of its gross domestic product per capital on child health and welfare programs, compared to other wealthy nations.” These programs also affect child health.
The country’s worst white infant mortality rate is better than its best black rate.
African-American infant mortality rates are 2.2 times higher than those of non-Hispanic whites. They were 3.2 times more likely to die from complications due to low birth weight, and experienced more than twice the rate of Sudden Infant Death Syndrome (SIDS). The infant mortality rate in Mississippi is the highest in the country. At 9.4 deaths per thousand, that state is closer to Botswana, and Sri Lanka than it is to the overall United States.
The mortality rate for black infants ranged from a low of 8.27 per 1,000 in Massachusetts to a high of 14.28 in Wisconsin. That means a black infant born in Wisconsin faces the same likelihood of death as an infant born in the West Bank of Palestine. She or he is more likely to die than an infant born in Colombia, or Jamaica, or Venezuela, or Tunisia.
A 2017 survey conducted by NPR, the Robert Wood Johnson Foundation, and the Harvard School of Public Health found that more than half of African Americans reported that they did not go to the doctor when they needed care because of cost. 58 percent of Hispanic-Americans reported that they did not seek medical care because of the cost.
Infants born Washington D.C.’s poorest neighborhood were ten times more likely to die than its richest infants. That neighborhood, Ward 8, was 93.5 percent black at the time. It also found that the nation’s capital has a higher infant mortality rate than any other capital in the developed world. Another recent infant mortality report found something else significant: The white, non-Hispanic infant mortality rate ranged from a low of 2.52 deaths per 1,000 in the Washington, DC to a high of 7.04 in Arkansas.
people of color are hardest hit by poverty. Although they are not the largest group of the poor, they are disproportionately affected because they are minorities. Overall, only 14 percent of white toddlers and infants in this country is poor. By contrast, 42 percent of all black children in this group are poor. So are one-third of all Hispanic children, and 37 percent of Native American children.
A 2011 study compared World Health Organization data from the U.S. and 19 countries and found that the U.S. had the worst child mortality rates. Using a UNICEF standard of measurement, it concluded that “the USA health care system appears the least efficient and effective in ‘meeting the needs of its children’.”
The needs of working women are also a subject of political neglect. Wage theft, unplanned shift changes, low wages, hostile work environments, lack of family leave: all these factors make life hard for working mothers to provide for their children, give them a healthy environment, and get them the medical care they need.
The new study authors said their findings support the conclusions of the Institute of Medicine, which blamed a fragmented health system, poverty, a weak social safety net and other factors for ‘poor health outcomes’ in the U.S.
A 2002 report from the Institute of Medicine (U.S.) Committee on the Consequences of Uninsurance concluded that “Uninsured women receive fewer prenatal care services than their insured counterparts and report greater difficulty in obtaining the care that they believe they need” and that “Health insurance status affects the care received by women giving birth and their newborns. Uninsured women and their newborns receive, on average, less prenatal care and fewer expensive perinatal services.” It concluded, “Uninsured newborns are more likely to have adverse outcomes, including low birth weight and death, than are insured newborns.”
Environmental problems plague lower-income communities and communities of color. Five of the environmental injustices faced by communities of color, include higher exposure to air pollution; greater proximity to landfills, toxic waste sites, and industrial facilities; higher rates of lead poisoning; water contamination; and greater vulnerability to the effects of climate change. An in-depth report in Scientific American, “Pollution, Poverty and People of Color: Children at Risk,” detailed the harmful health effects of environmental pollution and chronic stress. A report for the Philadelphia Department of Health outlined the harmful impact of inadequate housing on children’s health. Housing can cause or exacerbate asthma, lead poisoning, and physical injury, and can inflict emotional harm on both parents and children. Childhood obesity is worse among poor children, and its effects are more severe.
Some people can afford all the medical treatment they need. Others, even those with health insurance, struggle to get needed care. Others have no way of affording it. And our system permits financial exploitation by pharmaceutical companies and other for-profit players, leaving less money for actual care. Healthcare remains inaccessible to millions of Americans, with that number about to increase dramatically.