Whether an American baby lives or dies depends in part on where in the US it is born. Infant mortality—that is, a baby's ability to survive to its first birthday—varies greatly by state. The overall US infant mortality rate is 5.8 deaths per 1,000 live births—respectable, though below other wealthy developed nations—but individual states are another matter. Infants die at the highest rates in the deep south, with Mississippi, Louisiana and Alabama topping the list. Infant mortality rates in those states are on par with those in Botswana and Thailand. The safest place to have a baby? Along the coast and parts of the midwest, with Massachusetts, Iowa and Vermont leading the way, with rates closest to those of the United Kingdom or Canada.
Our healthcare system is known worldwide for being both state-of-the-art and extremely costly, so how can so much money yield such poor results in some regions? An analysis from economists Alice Chen, Emily Oster and Heidi Williams finds that it is not hospitals that are failing, but rather what happens after a baby leaves the sanitized, professional safety of a medical facility that differs from the rest of the developed world. For the poorest and most disenfranchised mothers in the US, something happens between taking a baby from the hospital and getting to that first-year milestone. The issue boils down to poverty—and policy.
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