Despite gains in reducing infant mortality, many countries lag behind

Leading the news this week on Harvard’s World Health News (WHN) website is the dire infant mortality crisis facing Milwaukee, Wisconsin. The article is available here and more information on confronting the infant mortality crisis are available here. The headline reminded me of a similar story in the New York Times more than a year ago. (After a little digging, I realized the NYT article also addressed infant mortality in the same community, as well as the many interventions to decrease the rates.)

The article from Harvard’s WHN, available at Milwaukee’s Journal Sentinel, drew comparisons to the infant mortality crisis globally and noted that:

In Milwaukee, the infant mortality rate for all children, regardless of race, exceeds that of Uruguay, Bosnia or Kuwait.”

And again, like many other aspects of health across the United States, there is great disparity between Blacks and Whites. The article goes on to say that:

In 2008, the infant mortality rate for whites was 5.9 per 1,000 births. It was 13.8 for blacks. That means that in Wisconsin, black infants die during their first year of life at more than twice the rate of white infants. It is worse than Romania. It is among the worst in the nation.

This article led me to seek out infant mortality rates for the Caribbean region, seeing that Target 4A for the Mellenium Development Goals is to reduce under-5 mortality rates by 2015.

According to UNICEF, many regional countries have met or exceeded their goals, including Dominica, Grenada and St. Kitts and Nevis. The full report is available here. Countries such as Barbados, Trinidad and Tobago, St. Vincent and the Grenadines and St. Lucia are on pace to meet their goals. However, the reported cited Jamaica and Haiti as two countries lagging behind. In fact, the report said that Haiti is the only country in the region with infant mortality greater than 1 in 10; while Jamaica was the only country in the region to not report a drop in under five mortality rate during the 1990’s.

Now, I understand that much has changed since the compiling of the data, and where possible I will attempt to get updated data. As of 2004, the last year available for the UNICEF Child Survival Report Card, the annual rate of reduction slowed in the 1990’s after increasing sharply from the 1960’s through the 1980’s.

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We as a region face many challenges. And there are varying social, economic, historical,  cultural, biological and possibly political reasons for high and or/low infant mortality rates. My attempt is not draw conclusions on why one country experienced a drop and another did not. I also do not attempt to draw comparison between Milwaukee and the Caribbean, but instead, I wanted to use it as a starting point for further discussion. My hope is that someone who wants to study child mortality rates in the Caribbean or elsewhere can build on what I’ve given here. Even though many countries in the Caribbean experience a decline in infant mortality rates, I am interested in knowing whether any disparities exist between majority and minority populations in certain countries, for example, between people of African decent and Indigenous groups in Dominica or St. Vincent; between those of African decent and of South-Asian decent in Guyana and Trinidad. Data such as this will help us as a region better understand the complexities of the health of the public and to target limited resources to groups who need them most.

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