$20.00
$15.00
$5.00
Recommend
3 
 Thumb up
 Hide
38 Posts
1 , 2  Next »   | 

BoardGameGeek» Forums » Everything Else » Religion, Sex, and Politics

Subject: US Maternal Mortality Rate Similar to Iran's rss

Your Tags: Add tags
Popular Tags: abort!_abort!_abort! [+] [View All]
United States
flag msg tools
Bitter and Acerbic Harridan
This study is getting a lot of press.
https://www.sciencedaily.com/releases/2016/08/160810113704.h...

The major points appear to be:

1. The estimated maternal mortality rate in the U.S., excluding California and Texas, was 23.8 per 100,000 live births in 2014- up from 18.8 in 2000.

2. 157 of 183 countries have shown decreases in their maternal mortality rates since 2000.

3. The current estimated U.S. rate is comparable to that of Iran and Ukraine.

4. Among 31 industrialized countries, only Mexico has a poorer mortality rate.

5. California showed a marked decline in maternal mortality from 2003 to 2014.

6. Texas had a doubling of its reported mortality rate in 2011-2012.


Questions for others.
I've refrained on speculating on reasons here as I'd rather hear what people say.

What do people think is causing the overall increase in mortality nationwide?

Why is our country doing so poorly on this front as compared at least 30 other industrialized nations? Even more concerning, why is it trending up not down like it is in most other countries?

Why are we doing as badly as a country like Iran? Are there things that are similar between the two?

Why is the rate down in California?

Why has the rate doubled so suddenly in Texas during such a tight time frame?

4 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Pontifex Maximus
United States
CA
flag msg tools
mbmbmbmbmb
she2 wrote:
This study is getting a lot of press.
https://www.sciencedaily.com/releases/2016/08/160810113704.h...

The major points appear to be:

1. The estimated maternal mortality rate in the U.S., excluding California and Texas, was 23.8 per 100,000 live births in 2014- up from 18.8 in 2000.

2. 157 of 183 countries have shown decreases in their maternal mortality rates since 2000.

3. The current estimated U.S. rate is comparable to that of Iran and Ukraine.

4. Among 31 industrialized countries, only Mexico has a poorer mortality rate.

5. California showed a marked decline in maternal mortality from 2003 to 2014.

6. Texas had a doubling of its reported mortality rate in 2011-2012.


Questions for others.
I've refrained on speculating on reasons here as I'd rather hear what people say.

What do people think is causing the overall increase in mortality nationwide?

Why is our country doing so poorly on this front as compared at least 30 other industrialized nations? Even more concerning, why is it trending up not down like it is in most other countries?

Why are we doing as badly as a country like Iran? Are there things that are similar between the two?

Why is the rate down in California?

Why has the rate doubled so suddenly in Texas during such a tight time frame?



The last one probably has to do with the Clampdown on planned parenthood documented in another thread

https://www.boardgamegeek.com/thread/1624927/texas-has-highe...

The third one probably corresponds to the the Texas answer.

If there is a state by state breakdown, we might be able to discern why the overall drift downwards (given the GOP having power in so many state legislatures now)

 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Isaac Citrom
Canada
Montreal
Quebec
flag msg tools
mbmbmbmbmb

The first obvious things that comes to my mind is a correlation between the higher MMR and the closure of Planned Parenthood facilities.

It seems like people are just guessing because everyone seems to be repeating the little bit from the abstract blurb of the study. To see the study, one has to pay.

I looked at the MMR by country. Firstly, there are some positions that make me doubt. For example, Estonia is number one in the World, and the bastions of healthcare, Belarus and Poland are 5 and 10 respectively; hmmm. But, I'm used to doubting the reporting figures of various classes of countries.

Having said that, indeed is the United States is at the bottom of the list of countries whose figures I trust and are fully developed.

As to the rise in the MMR, I sure would like to see the study and see what data is collected. Are they capturing cultural groups? I know the trend now is to characterize that information as "irrelevant." I wholly don't agree. So, for example, I'm asking whether the rise in Texas is related to a large influx of Mexicans, especially pregnant women in the second and third trimester. Are Mexicans less healthy as a group? Are these questions allowed to be asked?

Then again, with the same thinking, there ought to be a rise in California as well, and there isn't a rise. What about the other southern states?

I'm not convinced that there is a correlation between Planned Parenthood in Texas and this rise. Related to that, surely that PP provides condoms, other birth control, abortions, and screening for cancer is not related to the MMR. What else does PP do that relates to MMR (nutrition counseling, ultrasounds, ??)?
.
1 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Steve Fitt
Thailand
Chang Mai
flag msg tools
isaacc wrote:
I'm not convinced that there is a correlation between Planned Parenthood in Texas and this rise. Related to that, surely that PP provides condoms, other birth control, abortions, and screening for cancer is not related to the MMR. What else does PP do that relates to MMR (nutrition counseling, ultrasounds, ??)?
.

Isaacc, I think that a case could easily be made to link abortions and MMR.

A woman who was told that she had a problem with her pregnancy and couldn't or didn't have an abortion could die in childbirth.

If the total number of Maternal deaths was very low to start with just a few additional deaths could double the rate in 1 year.


3 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Based upon my poor understanding of history, science, and ethics...
United States
North Pole
Alaska
flag msg tools
Since we're speculating, I throw out the heroin/narcotic epidemic as a possible factor.

Edit: before the ignorant pipe up, I'll clarify: I'd suspect drug addicts are more hesitant to visit a doctor, and lead a lifestyle that is not in a pregnant woman's best interest.
1 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Kelsey Rinella
United States
Rochester
New York
flag msg tools
I am proud to have opposed those who describe all who oppose them as "Tender Flowers" and "Special Snowflakes".
badge
Check out Stately Play for news and reviews of games worth thinking about.
mbmb
Koldfoot wrote:
Since we're speculating, I throw out the heroin/narcotic epidemic as a possible factor.


That doesn't seem to explain why Texas is worse than other states; it appears to be doing pretty well in drug poisoning deaths. It's not even in the top 20 states for drug overdose deaths (or bottom--this is a bit like the "positive" result on a cancer screening).

 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Andrew Bartosh

Sunnyvale
California
msg tools
mbmbmbmbmb
rinelk wrote:
Koldfoot wrote:
Since we're speculating, I throw out the heroin/narcotic epidemic as a possible factor.


That doesn't seem to explain why Texas is worse than other states; it appears to be doing pretty well in drug poisoning deaths. It's not even in the top 20 states for drug overdose deaths (or bottom--this is a bit like the "positive" result on a cancer screening).



Could be that Texas drug users are just decent at actually using them themselves, just not so great at helping their babies handle it.
 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Based upon my poor understanding of history, science, and ethics...
United States
North Pole
Alaska
flag msg tools
rinelk wrote:
Koldfoot wrote:
Since we're speculating, I throw out the heroin/narcotic epidemic as a possible factor.


That doesn't seem to explain why Texas is worse than other states; it appears to be doing pretty well in drug poisoning deaths. It's not even in the top 20 states for drug overdose deaths (or bottom--this is a bit like the "positive" result on a cancer screening).



I'll speculate again.

Ever hear the fact that the best doctors in their fields have the highest death rates amongst their patients?

It's true in many cases, and it's true because the worst cases get referred to them.

Mexico has high rates, as cited in the link. It could be that high risk women wisely travel across the border to deliver. Texas and California are both singled out. Could be something there.
 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Andrew Bartosh

Sunnyvale
California
msg tools
mbmbmbmbmb
Koldfoot wrote:
Mexico has high rates, as cited in the link. It could be that high risk women wisely travel across the border to deliver. Texas and California are both singled out. Could be something there.


I'd be quite curious to see regional numbers for CA on that note. The state is big enough that comparison of NorCal and SoCal might be additionally informative.
 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Kelsey Rinella
United States
Rochester
New York
flag msg tools
I am proud to have opposed those who describe all who oppose them as "Tender Flowers" and "Special Snowflakes".
badge
Check out Stately Play for news and reviews of games worth thinking about.
mbmb
Koldfoot wrote:
rinelk wrote:
Koldfoot wrote:
Since we're speculating, I throw out the heroin/narcotic epidemic as a possible factor.


That doesn't seem to explain why Texas is worse than other states; it appears to be doing pretty well in drug poisoning deaths. It's not even in the top 20 states for drug overdose deaths (or bottom--this is a bit like the "positive" result on a cancer screening).



I'll speculate again.

Ever hear the fact that the best doctors in their fields have the highest death rates amongst their patients?

It's true in many cases, and it's true because the worst cases get referred to them.

Mexico has high rates, as cited in the link. It could be that high risk women wisely travel across the border to deliver. Texas and California are both singled out. Could be something there.


Except that California was mentioned because its rate has fallen dramatically, not because it had an unusually high rate. And Texas' rate doubled between 2011 and 2012, a year during which Mexico's rate continued a fairly steady decline. Texas' rate was otherwise pretty stable.


(From here).

Similarly, the measures which hit Planned Parenthood so hard seem to have taken effect in 2013; they don't seem to have caused an increase at all. That's actually a little surprising, because they do seem to have caused a big increase in low-income women having babies rather than using birth control. You'd expect that health outcomes for low-income women would be worse across the board than for the wealthy, so that would have been a very plausible explanation. But the timing doesn't seem to work out right.

EDIT: Aha! Apparently Texas cut family planning funding by 2/3 in 2011. The latest round of Planned Parenthood shenanigans were more targeted, but not the first. So, um, yeah--that seems like a pretty strong candidate explanation.

5 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Based upon my poor understanding of history, science, and ethics...
United States
North Pole
Alaska
flag msg tools
I didn't realize this thread was intended to celebrate a 50% higher abortion rate in California.

Yeah. That is a noob mistake.

For rational people I'll toss this out, then bow out of the thread. Accept my apology for assuming the OP was serious. My thoughtful speculation was like a dog turd in the salad bar.

California is very near the bottom in average age, and high risk pregnancies are more associated with older women.
 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Kelsey Rinella
United States
Rochester
New York
flag msg tools
I am proud to have opposed those who describe all who oppose them as "Tender Flowers" and "Special Snowflakes".
badge
Check out Stately Play for news and reviews of games worth thinking about.
mbmb
Koldfoot wrote:
I didn't realize this thread was intended to celebrate a 50% higher abortion rate in California.


Oh, hey, it's THIS game! Can I play?

I didn't realize this was the thread in which anti-abortion ideologues admit that abortion is safer than childbirth, and therefore that every pregnant woman has a legitimate medical reason to have access to abortion on demand.

Actually, this is a terrible game.
9 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
David Dearlove
United Kingdom
Isleworth
Middx
flag msg tools
mbmbmbmbmb
Koldfoot wrote:
Since we're speculating, I throw out the heroin/narcotic epidemic as a possible factor.

Edit: before the ignorant pipe up, I'll clarify: I'd suspect drug addicts are more hesitant to visit a doctor, and lead a lifestyle that is not in a pregnant woman's best interest.

Or it could just be that you make poor people pay for medical care.
5 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
United States
flag msg tools
Bitter and Acerbic Harridan
In another thread, the subject of midwives and home births came up with two different posters coming to different conclusions on the impact. Does anyone know how the US ranks in terms of home births as compared to other industrialized nations (i.e., compared to places like Europe, etc.)? And does anyone know the statistics on women's mortality rates (not infant deaths) as a function thereof?
1 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
United States
flag msg tools
Bitter and Acerbic Harridan
Another factor raised was C-sections here versus other places. Any ideas about that from the more knowledgeable?

**As a side note, I'm quite uninterested in turning this into an abortion debate. The stats in TX are so stark in a short period that you'd have to be blind to see that the huge cuts in family planning cuts in TX in 2011 are probably largely to blame. A very large number of clinics closed and only about 1/3 of them were Planned Parenthood associated. A number also did not provide abortion services but were caught up in this because of an affiliation with the organization. If there was a corresponding surge in pregnancies being carried to term, then you can see why the cut in prenatal care, however unintentional, would create a perfect storm for this kind of thing. Not to mention that Texas is a huge state geographically with long distances to travel. Then you can also add in the illegal immigrant population who would be severely impacted.

http://www.latimes.com/science/sciencenow/la-sci-sn-planned-...
3 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Moshe Callen
Israel
Jerusalem
flag msg tools
designer
ἄνδρα μοι ἔννεπε, μοῦσα, πολύτροπον, ὃς μάλα πολλὰ/ πλάγχθη, ἐπεὶ Τροίης ἱερὸν πτολίεθρον ἔπερσεν./...
badge
μῆνιν ἄειδε θεὰ Πηληϊάδεω Ἀχιλῆος/ οὐλομένην, ἣ μυρί᾽ Ἀχαιοῖς ἄλγε᾽ ἔθηκε,/...
mbmbmbmbmb
she2 wrote:
In another thread, the subject of midwives and home births came up with two different posters coming to different conclusions on the impact. Does anyone know how the US ranks in terms of home births as compared to other industrialized nations (i.e., compared to places like Europe, etc.)? And does anyone know the statistics on women's mortality rates (not infant deaths) as a function thereof?

Here are 3 links from a few seconds googling. I've not vetted them but the appear at least to be from reliable sources (well, except for the NYT):
http://time.com/12080/explaining-the-latest-numbers-on-home-...
http://www.nytimes.com/2016/05/01/opinion/sunday/why-is-amer...
https://www.cdc.gov/nchs/data/databriefs/db84.pdf

On midwives:
http://www.who.int/mediacentre/news/releases/2014/investment...
2 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
United States
flag msg tools
Bitter and Acerbic Harridan
whac3 wrote:
she2 wrote:
In another thread, the subject of midwives and home births came up with two different posters coming to different conclusions on the impact. Does anyone know how the US ranks in terms of home births as compared to other industrialized nations (i.e., compared to places like Europe, etc.)? And does anyone know the statistics on women's mortality rates (not infant deaths) as a function thereof?

Here are 3 links from a few seconds googling. I've not vetted them but the appear at least to be from reliable sources (well, except for the NYT):
http://time.com/12080/explaining-the-latest-numbers-on-home-...
http://www.nytimes.com/2016/05/01/opinion/sunday/why-is-amer...
https://www.cdc.gov/nchs/data/databriefs/db84.pdf

On midwives:
http://www.who.int/mediacentre/news/releases/2014/investment...


Thanks. I'll look at these, Moshe. It does strike me that this can't be the biggest factor given the impact of prenatal care on health. Also the study included maternal deaths that were not during child birth, but after birth or termination like due to a miscarriage.
 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Christopher Dearlove
United Kingdom
Chelmsford
Essex
flag msg tools
SoRCon 8 27 Feb - 1 Mar 2015 Basildon UK http://www.sorcon.co.uk Essex Games 27 Jul '15
badge
mbmbmbmbmb
DavidDearlove wrote:
Koldfoot wrote:
Since we're speculating, I throw out the heroin/narcotic epidemic as a possible factor.

Edit: before the ignorant pipe up, I'll clarify: I'd suspect drug addicts are more hesitant to visit a doctor, and lead a lifestyle that is not in a pregnant woman's best interest.

Or it could just be that you make poor people pay for medical care.


That might explain a generally high rate. But not on its own the doubling in Texas. (I'm assuming Texas is sufficiently large that the doubling is significant, but that would need verification.) The reduction in Planned Parenthood (coupled with a need for it) is a plausible hypothesis, but it needs work (such as do the timescales align, allowing for delays in the system - one of which is up to nine months long).
 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Moshe Callen
Israel
Jerusalem
flag msg tools
designer
ἄνδρα μοι ἔννεπε, μοῦσα, πολύτροπον, ὃς μάλα πολλὰ/ πλάγχθη, ἐπεὶ Τροίης ἱερὸν πτολίεθρον ἔπερσεν./...
badge
μῆνιν ἄειδε θεὰ Πηληϊάδεω Ἀχιλῆος/ οὐλομένην, ἣ μυρί᾽ Ἀχαιοῖς ἄλγε᾽ ἔθηκε,/...
mbmbmbmbmb
One factor no one has mentioned is that Texas used to be welcoming to illegal immigrants whose only crime was to cross the border. I gather that has changed and so people who previously would seek antenatal care are likely not doing so anymore because they're scared of being deported. That threat is all the more dangerous to a pregnant woman. So people who live in poverty are likely increasingly scared to get decent medical care during pregnancy.
3 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Chris
United States
Sandy Springs
Georgia
flag msg tools
mbmbmbmbmb
I think the high mortality rate is mostly due to drugs. I don't have facts but just a gut feeling. I used to work in a hospital, not as a nurse but in IT so I definitely not an expert. But I would hear the most fucked up shit when I was in Pediatrics or L&D depts and it was usually due to drug stuff.
1 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
United States
flag msg tools
Bitter and Acerbic Harridan
galad2003 wrote:
I think the high mortality rate is mostly due to drugs. I don't have facts but just a gut feeling. I used to work in a hospital, not as a nurse but in IT so I definitely not an expert. But I would hear the most fucked up shit when I was in Pediatrics or L&D depts and it was usually due to drug stuff.


Someone pointed out the meth epidemic, but if that were the cause of TX, we'd have seen a greater spike in Indiana. I agree it's one factor nationwide though.
 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Donald
United States
New Alexandria
Pennsylvania
flag msg tools
mbmbmbmbmb
whac3 wrote:
One factor no one has mentioned is that Texas used to be welcoming to illegal immigrants whose only crime was to cross the border. I gather that has changed and so people who previously would seek antenatal care are likely not doing so anymore because they're scared of being deported. That threat is all the more dangerous to a pregnant woman. So people who live in poverty are likely increasingly scared to get decent medical care during pregnancy.


Would those people be part of the statistics? If they're avoiding doctors and hospitals all together, would their families risk getting caught when it was too late?

 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
Moshe Callen
Israel
Jerusalem
flag msg tools
designer
ἄνδρα μοι ἔννεπε, μοῦσα, πολύτροπον, ὃς μάλα πολλὰ/ πλάγχθη, ἐπεὶ Τροίης ἱερὸν πτολίεθρον ἔπερσεν./...
badge
μῆνιν ἄειδε θεὰ Πηληϊάδεω Ἀχιλῆος/ οὐλομένην, ἣ μυρί᾽ Ἀχαιοῖς ἄλγε᾽ ἔθηκε,/...
mbmbmbmbmb
Donald wrote:
whac3 wrote:
One factor no one has mentioned is that Texas used to be welcoming to illegal immigrants whose only crime was to cross the border. I gather that has changed and so people who previously would seek antenatal care are likely not doing so anymore because they're scared of being deported. That threat is all the more dangerous to a pregnant woman. So people who live in poverty are likely increasingly scared to get decent medical care during pregnancy.


Would those people be part of the statistics? If they're avoiding doctors and hospitals all together, would their families risk getting caught when it was too late?


They're still going to hospitals and doctors but only when they have to.
3 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
United States
flag msg tools
Bitter and Acerbic Harridan
whac3 wrote:
Donald wrote:
whac3 wrote:
One factor no one has mentioned is that Texas used to be welcoming to illegal immigrants whose only crime was to cross the border. I gather that has changed and so people who previously would seek antenatal care are likely not doing so anymore because they're scared of being deported. That threat is all the more dangerous to a pregnant woman. So people who live in poverty are likely increasingly scared to get decent medical care during pregnancy.


Would those people be part of the statistics? If they're avoiding doctors and hospitals all together, would their families risk getting caught when it was too late?


They're still going to hospitals and doctors but only when they have to.


And they'd be using clinic services quite a bit which were impacted by the 2/3 cut in funding in 2011.
3 
 Thumb up
0.01
 tip
 Hide
  • [+] Dice rolls
Christopher Dearlove
United Kingdom
Chelmsford
Essex
flag msg tools
SoRCon 8 27 Feb - 1 Mar 2015 Basildon UK http://www.sorcon.co.uk Essex Games 27 Jul '15
badge
mbmbmbmbmb
galad2003 wrote:
I don't have facts but just a gut feeling.


The Republican Party platform in a nutshell.
9 
 Thumb up
 tip
 Hide
  • [+] Dice rolls
1 , 2  Next »   | 
Front Page | Welcome | Contact | Privacy Policy | Terms of Service | Advertise | Support BGG | Feeds RSS
Geekdo, BoardGameGeek, the Geekdo logo, and the BoardGameGeek logo are trademarks of BoardGameGeek, LLC.