Considering America's Infant Mortality Rate

http://politics.slate.msn.com/id/2161899/

Given the nature of our device design project this semester, I feel it's important to look at some of the societal and political issues associated with infant mortality and premature births. Last year, a group funded by the Bill and Melinda Gates Foundation released a report that stated that the United States tied with Malta and Slovakia for the second worst infant mortality rate among developed nations. While poorer nations struggle with infection-related deaths, complications associated with prematurity account for at least a third of infant mortality in the United States. Despite much financial investment and research into preventing and aiding premature babies, the statistics remain obstinately high.

In a recent Slate article, Darshak Sanghavi presents a counterintuituive explanation for our infant mortality probem: we may be spending too much on healthcare. Not only have the increasing use of in vitro fertilization and other assisted reproductive technologies increased the number of women undergoing high risk pregnancies, the increasing availability of neonatal intensive care units may actually be detrimental to premature infants. He points out a 2002 New England Journal of Medicine study where the authors found that high regional NICU availability did not correlate with need or improved infant mortality rates. Summarizing the conclusions from the 2002 study, Sanghavi points out that NICUs have a high profit potential and may be created for primarily that purpose. Furthermore, NICU availability may cause some patients to undergo high risk diagnostic and therapeutic procedures that may not be necessary. Fewer NICUs also concentrate experience and expertise, providing better outcomes for patients.

Ultimately, Sanghavi suggests that diverting patients to a smaller number of hospitals would be a sensible plan for reducing infant mortality.