While our congress pats itself on its fanatical dedication to gutting health care, women are dying. This is a chart of maternal mortality in pregnancy per 100,000 live births.
Our health care system, among many other things, is broken. It is not the will of God or manifest destiny or any kind of positive American exceptionalism, because as the chart clearly shows, other countries do not have this problem to the same degree we have, and while they’re working to improve public health, we’re doing our damnedest to worsen it.
Thanks, regressive Republican vermin. You’re all traitors to humanity as well as to your country.
Obviously there is a big gap between 200 and 2015, but that graph would seem to suggest that things got worse even with the ACA.
One wonders how those figures break down in terms of wealth and ethnicity. I would expect there to be a very low percentage – maybe about 2-3% – that accounts for serious obstetric issues that are dangerous however much care you have access to, and everything on top of that to be disproportionately skewed towards the poor (who, particularly in the US, are often minorities). I wouldn’t be at all surprised to learn that America’s 15% lead over the rest of the developed world is mostly black people.
The fact that there was a recent popular TV series based around a man manufacturing industrial quantities of crystal meth to pay his medical bills tells you all you need to know about the American health”care” system.
Sorry, not percent, per hundred thousand.
Ye Pfffft! of All Knowledge fills in one of the missing datapoints (see link for sources):
Regarding the possible increasing maternal death rate with ACA, to what extent would the refusal to implement the Medicaid expansion (in many thug-controlled States) have had an effect here?
(Earlier today, weirdly, I was having a conversation about health care, and noted that a common measure of its quality is infant mortality. I said, without checking, that the USA has an “off the charts” rate compared to other developed countries. I just checked, and whilst not quite “off the charts”, it is astonishingly high. (I forgot about maternal deaths.))
The World Bank’s modeled estimate for the USA’s maternal mortality rate shows it flatlining at c.14 since 2006, except for 2009, when it jumped to c.15. (The model only runs to 2015.)
Those values do not agree at all with the ones in the chart in the OP. I have no idea why.
“Working to improve public health”? The current UK government is doing everything it can to destroy the country’s public health system and implement the American model instead. Not that that is any consolation.
It is even worse than PZ says.
Texas has the highest maternal mortality rate in the developed world.
It’s gone up sharply, just recently.
It coincides with the Texas GOP war on women and health care.
raven@8, Thanks for quoting your source! However, the link, whilst not borked, is not too useful, linking only to the Grauniad’s site, and not the specific article. Here is a link to the actual article, Texas has highest maternal mortality rate in developed world, study finds (Aug-2016): “As the Republican-led state legislature has slashed funding to reproductive healthcare clinics, the maternal mortality rate doubled over just a two-year period”.
Some of the increase may be due to the fact that the US recently changed how they track the data and the fact that the US tracks more data on this than some other countries (a fact that also comes up when people talk about perinatal mortality as some countries do not count premies under a certain birth weight nor some premies under a certain number of weeks in their statistics):
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001799/
“Studies based on data from the 1980s and 1990s identified significant underreporting of maternal deaths… To improve ascertainment, a pregnancy question was added to the 2003 revision of the U.S. standard death certificate…”
http://journals.lww.com/greenjournal/Fulltext/2017/01000/Factors_Underlying_the_Temporal_Increase_in.12.aspx
“Our study suggests that the reported substantial increase in maternal mortality in the United States between 1993 and 2014 was likely a consequence of improvements in maternal death surveillance and changes in the coding of maternal deaths. Regression adjustment for the separate pregnancy question on death certificates, ICD-10 codes, and the standard pregnancy checkbox on death certificates eliminated the increase in maternal mortality rates between 1993 and 2014. Exclusion of maternal deaths associated with the four new ICD-10 codes that identified late maternal deaths (O96, O97), other specified pregnancy-related conditions (O26.8), and other maternal diseases classifiable elsewhere (O99) also abolished the temporal increase in maternal mortality between 1999 and 2014.”
Late maternal deaths in these statistics also include indirect causes including accident, homicide and suicide. ( under ICD-10 codes)
The graph displayed is not attributed. This site (http://data.worldbank.org/indicator/SH.STA.MMRT ) gives a substantially lower figure for 2015 of 14. Still significantly higher than the rest but arguably the rest have been cherry picked. Other countries not on the list include Hungary (17). Luxembourg (10) New Zealand (11) UK (9). There is also disagreement with a 1990 figure of 12, not 17. Arguably a rise from 12 to 14 is of limited significance, but most other countries have shown a fall so there is a definite effect. I’m not saying the graph here is wrong, but certainly other reputable sites seem not to correspond.
pointinline@11, As I pointed out in @6. the World Bank’s graph is based on an (unspecified?) model, whilst the OP’s graph source is, as you say, unattributed. In other words, in both cases, there is insufficient information provided to assess the reliably, etc., and lack thereof, of the graphed “data”.
The CIA factbook gives the USA’s 2010 rate as 21, closer to the OP’s graph than the the World Bank’s model.
A possible clew to what is going on is in Ye Pffft! of All Knowledge (my added emphasis):
The MMRatio for the USA is given as 12 (1990), 12 (2000), 14 (2015), broadly matching the World Bank’s model, but the OP. However, the above-linked CIA factbook says it is giving the MMRate (21 in 2010, similar to the OP but not the World Bank model), suggesting the OP is MMRate, not MMRatio.
So what the feck is the difference between the two MMRs? I’m unclear. Ye Pffft! of All Knowledge says:
That makes it sound like MMRate has nothing per se to do with childbirth (or pregnancy), other then age of the woman, whilst MMRatio is directly connected with the woman’s childbirth / pregnancy. (I could easily be misinterpreting here!)
The hypothesis that some graphs / figures are MMRate (women of child-bearing age), whilst others are MMRatio (childbirth / pregnancy) could explain the discrepancies. This hypothesis would predict the MMRate is higher than the MMRatio — women of child-bearing age can and do die for reasons unrelated to childbirth / pregnancy — which does seem to be the case in the various quoted data sets (when it is know what the data is).
Both figures are quite poor for the USA, in comparison with other developed countries.
# 11pointinline
The graph displayed is not attributed
Well it sorta is. You just have to keep clicking on things. The data seems to come from http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31470-2.pdfhttp://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31470-2.pdf or http://www.thelancet.com Vol 388 October 8, 2016.
The authors (all 1000 or so) present a huge table which looks like it includes summary stats for the 186 countries for which they could get data. I would say that whoever made up the graph did not cherry pick so much as had so much data that they may have had to just pick a few that seemed reasonable. You could probably build 100 different graphs using some reasonable set of criteria such as modern first-world county, reasonably functioning economy, stable political situation, decent healthcare.
BTW their estimate for Hungary for 2015 is 9.
I think the main thing is that from just looking at a few countries is that in many, probably most, cases the trend is downward and the US trend is startling upward. I’d agree that some of this is likely due to some changed definitions but it looks unlikely to be that big a jump.
I just skimmed the abstract a few bits and pieces of the rest of article and it looks like they built their own database using a number of different data sources and, probably, had to make some decisions on the counting rules by fiat but it is not all that surprising that estimates of other reports are not quite the same. In some cases they may not even be measuring the same things as WHO does.
Building such a database is amazingly difficult: Are the criminal assault rates directly comparable between the USA and Canada? No they are not.
Is a housing subsidy in Canada and Switzerland the same thing? Damfino. What constitutes a homicide in Afghanistan? Good luck.
@phlo Not defending the Tories record on the NHS as I don’t believe they’re funding it properly but there’s no way that the British public would accept the (inhumane) American health system.
I’m not a Conservative but I’m pretty sure even they realise the value of our “free at the point of delivery” service.
And yes, my glass is always half full!
@pigdowndog
I wish I could share your optimism. Britain has a Health Secretary that has literally written a book on how to privatise the NHS. Doctors and nurses are out on the streets protesting, if they haven’t already emigrated to Australia. A&E departments are being closed down. People are dying on trolleys in the corridors because no beds are available. Trainee nurses’ boursaries are being scrapped, leaving some of them in nothing short of poverty.
And yet the British electorate is bending over and taking it. I can’t see what miracle there is on the horizon that might save the NHS if the Tories get reelectec (which, unfortunately, appears likely).
@phlo. People also die in bed whilst in hospital. I can’t follow the logic of blaming the trolley. I can find two cases of this happening in 2017 which in the whole scheme of things is small fry. I agree with the nurses pay argument, that’s a scandal.
Five and a half thousand nurses emigrated last year but eight and a half thousand nurses immigrated from abroad.
Once again I agree that the system needs improving but I don’t subscribe to the over-hyped rantings about the failings of the NHS. In the past year I’ve had first hand experience as I’ve had three heart attacks (I’m 74) and the treatment was superb although the hospital I attended was badmouthed by all and sundry (Medway Maritime Hospital) so I tend to take the “voice of doom” merchants with a pinch of salt. You may be right about the Tories’ re-election but I think writing off Corbyn is a mistake.
@pigdowndog
I am not claiming that people were dying because they were left on trolleys. The issue here is the lack of beds and other resources. This is a symptom of the systematic underfunding at the hands of the current goverment.
More skilled medical professionals than ever consider leaving the country because of the working conditions in the NHS. Morale is at an all-time low. This article is from 2015, but it explains how many doctors feel – and things have gotten worse since then.
https://www.theguardian.com/society/2015/nov/08/nhs-doctors-in-australia-more-cash-fewer-hours-less-pressure
I have no problem believing this – the people who work in the NHS are great, their skills or attitudes are not the problem. The issue is that the government is consciously running the system into the ground to sell it off to people like Richard Branson.
I sincerely hope that you are right.
A recent Grauniad article on the low NHS pay rates & rises, NHS staff ‘quitting to work in supermarkets because of poor pay’: “Policy of limiting rises to 1% is damaging health service and must not be pursued into next parliament, say NHS leaders”.
I myself have had only good experiences with the NHS, albeit with the exception of two emergency calls, it’s always been of a routine / preventative nature. In every single interaction, the staff were brilliant and helpful and caring and supportive.
Srsly? They will privatise it, and impose point-of-delivery charges, just as soon and as far as they think they can get away with it politically – which is likely to be very far, if they win the kind of “landslide” predicted (I.e. a big majority on less than half the vote, as provided by the ludicrously undemocratic Westminster FPTP electoral system). The very idea that a public, state-run service could be superior to the “free market” is anathema to them, and a successful NHS thus represents an ideological irritant they find it hard to tolerate. Up to now, they have been constrained by the NHS’s huge popularity, but with a weak and divided opposition, and ready-made foreign scapegoats for whatever goes wrong over the next decade, I can’t see that lasting.
Incidentally, pigdowndog, I’m glad, and not surprised, you got excellent NHS treatment in emergencies. Emergency treatment is, rightly, prioritised. When it comes to more routine consultations and treatment, the inadequate staffing and resources are often far more evident – but a lot depends on where you live, and the hospital or GP surgery you end up in.
@Slugsie #1:
The advent of ACA came at the same point as the Republicans winning many state legislatures. They dismantled female healthcare in general, and maternity/contraceptive healthcare specifically. This caused maternal mortality and infant mortality to go up even as ACA should have caused it to go down. Maternal and infant mortality rates are going up, or at least stagnating, in just about every county of the United States. It is disgusting, and part of the problem does lie with the health “care” system in the US that can (in rare cases) have them looking up your insurance before taking a baby to the NICU.