As Zika makes its way north, pregnant women should be concerned about small babies, not only small heads. Despite being world-class and first-rate in every way, for at least a century, the United States has been satisfied in accepting the fact that some newborn babies just won’t make it, especially black ones.
Nearly seven babies die during their first year of life out of every 1,000 babies born in the United States, putting us in 27th place out of 30 OECD countries, behind Greece, Hungary and Portugal. Our ranking was 12th in 1960; we’ve obviously been falling behind in the country that spends more on health care than anyone else.
The most common cause of infant mortality is giving birth to a preterm (before 37 weeks gestation) or low birth weight (less than 5.5 pounds) baby. About one in 10 babies is born prematurely among white mothers compared with one in six among black mothers in the United States. And the rate of low birth weight is about twice as high for black mothers compared with white mothers. This racial disparity in negative birth outcomes has been documented for at least a century and should be alarming for anyone concerned about women’s and children’s health–that is, all of us.
A common notion is small and premature babies will by and large “catch up” in weight and live long and healthy lives; many of them fortunately do. However, what many people do not realize is that in addition to the tragic outcomes of dying during infancy, negative birth outcomes are also strongly predictive of multiple, serious disabilities for babies, not to mention the emotional and financial toll on their parents and our health care system. What may come as a surprise, moreover, is negative birth outcomes are also linked to chronic diseases and early death when those babies become adults.