U.S. Health Care: Reality Check on Cross-Country Comparisons

Commonly referenced reports maintain that the United States has inferior health outcomes compared to other countries, despite its higher health care spending per capita. But according to an American Enterprise Institute study, these conclusions are the result of shoddy research. For example:

Teenage mothers are more likely to have preterm, low-birth-weight babies. The mortality rate for infants born to U.S. teenage mothers is 1.5 to 3.5 times as high as the rate for infants born to mothers ages twenty-five to twenty-nine. The US rate of births for teenage mothers is very high — 2.8 times that of Canada and 7.0 times that of Sweden and Japan. If the United States had the same birth weights as Canada, its infant mortality rate — adjusting for this variable alone — would be slightly lower than Canada’s (5.4 versus 5.5 per one thousand births).

Comments (6)

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  1. Alex says:

    This is actually very important information in the discussion about U.S. healthcare.

  2. Ken says:


  3. Otis says:

    I predict that Obamacare will not lower the mortality rate for infants born in the U.S., on the whole.

  4. Devon Herrick says:

    Metrics, such as infant mortality, are commonly used as evidence the United States Health Care System is lower quality than OECD countries with National Health Care Systems. However, infant mortality is not a particularly good metric for comparison. What constitutes a live birth (as opposed to a stillborn) varies from one country to the next. Higher rates of miscarriage and premature birth (the cause of infant mortality) can vary based on genetic factors. Also, social issues unrelated to health care effect infant mortality.

  5. Dale says:

    Also, as the article notes, the various OECD countries define infant mortality vs stillbirth differently. Hard to compare when you have a difference in definitions.
    Overall, I thought the article was a good summary of the perils of using infant mortality and life expectancy to measure health care quality, but didn’t see much new there.

  6. City of London Private GP's says:

    This is great information. It’s important to have awareness of birthing stats within other countries.