Want to compare birth mortality rates?
Sure, let's compare. We're looking at the black box of health care, keep that in mind. You don't get to steal a base by penalizing the US for having a black population with a genetic predisposition towards higher infant mortality rates, higher twinning rates, higher rates of low birth weight babies, higher rates of very low birth weight babies, because none of these factors have anything to do with the black box of health care systems.
So let's start. Compare European to American white, that way we don't have racial confounding issues.
We first need to examine higher risk multiple births. Here's European data:
Here's American data. Pay attention to the non-Hispanic white rate. Our of curiosity you may want to note the naturally higher black rate. Would you look at that, the white multiple birth rate is 38.3 per 1,000 births, which is far higher than the European rates of multiple births. Why don't you take a wild guess as to WHY American women have a higher multiple birth rate.
What's associated with multiple births? How about low birth weight. Why don't we take a look at how many babies are born with low birth weight.
Would you look at that. European and American white rates of low birth weight and very low birth weight appear to be in the same range despite American women having noticeably higher rates of multiple birth. How much of a fetal mortality risk is associated with multiple birth? Here's some data, in Table E, we see that twins have a 2.87x higher risk of mortality than do singletons and multiples have a 4.87x higher risk of mortality.
Let me ask you, does the HEALTH SYSTEM have any influence over women presenting with twins or multiples?
Oh, while I have the chart below under discussion, look at Table D and note the American white rate of birth by women under 20, who represent 7.4% of all births and 9.5% of fetal deaths. This compares to rates in Switzerland of about 1% and a European mean (boosted by Eastern Europe) of about 5%.
So how risky is birth to women under the age of 20? A woman between ages of 15-19 actually has a higher rate of delivering at less than 34 weeks than a woman aged 35-39.
So now the ball is in your court. You said you wanted to talk about the superior European health system's influence on perinatal mortality rates. OK, show me your cards, show me a study which controls for race, controls for rates of multiple births, rates of older mothers and rates of younger mothers.
Let's see how the HEALTH SYSTEM delivers better results by excluding the factors which affect perinatal mortality rates but have nothing to do with the health care SYSTEM. And one other thing, you know, just to spice things up a bit, find a study which controls for vehicular accidents per 100,000 residents because the US, with it's wide expanses of roads, is a
world leader in this regard, with 11.6 deaths per 100,000 residents compared to 3.5 per 100,000 for countries like Ireland, and when a pregnant women suffers trauma due to a vehicular accident and loses her child, that death is counted in the perinatal mortality data but the death was not attributable to the health care system.
So yeah, let's compare - I want to see your studies which look at the effect of SYSTEM on OUTCOME.
