News analysis

Under the best of circumstances, it is hard for a poor, Third World country to equal, let alone surpass, the social statistics of wealthy developed countries. For years, Cuba has been passing all other relatively poor countries in its statistics on health, health care and education. It has now officially passed the United States of America, the richest country in the world, on one key measure of national well-being, namely, the infant mortality rate.

What is the infant mortality rate? It is a public health statistic, representing the number of babies per every 1,000 born in a given year who die before reaching their first birthday.

In mid-February, the U.S. Centers for Disease Control and Prevention in Atlanta revealed that the U.S. infant mortality rate now stands at 7 as of 2002, backsliding from 6.8 in 2001.

In early January, the Cuban Ministry of Health announced an infant mortality rate of 6.3, more than a half-point lower than the U.S.

Worldwide, the lowest infant mortality rates are generally found in countries which are both wealthy and have well-developed social safety networks, such as Sweden (which has an infant mortality rate of 3 – that is, out of every 1,000 babies born, 3 die before reaching their first birthday).

The countries with the worst infant mortality rates are those that are desperately poor and have a social safety net that is minimal or nonexistent, such as Afghanistan (infant mortality rate of 165) and many countries in sub-Saharan Africa.

The worldwide tendency is for infant mortality rates to go down, due to urbanization, improvements in sanitation, health advances, and other factors. What is remarkable about the Cuban achievement is that it has gone down so far so fast. Cuba’s rate is far better than those of the vast majority of countries of Asia, Africa and Latin America, wealthy economies such as those of Japan and Singapore excepted.

People who know Cuba don’t find the Cuban achievement surprising. They attribute it to the high level of education of the Cuban population, the supportive social networks that are encouraged by the Cuban socialist government, the investment of Cuba in public health and health care, and the low AIDS and drug addiction rates in Cuba. These things are made possible by Cuban socialism.

Only in a few places in the world do you find a trend toward worsening of the infant mortality rate. After the collapse of the Soviet Union, for example, infant mortality rates in the former Soviet republics in Central Asia skyrocketed, but are going down again in some places. The AIDS crisis is causing an increase in Southern Africa. And now we see an increase in the rate in the United States.

The Center for Diseases Control attributes the worsening of the infant mortality rate in the U.S. to the tendency of more women to have babies when they are already in their 30s and 40s, said to be a greater risk for the neonates. Even if this is accepted (which it should not be) as an excuse for such a negative development, it raises more questions than it answers, such as:

• How come the same thing is not happening in other developed, wealthy countries, where the demographic trends on childbirth are similar? And how does this breakdown among different racial, ethnic and economic subsections of the U.S. population? Could it be the atrocious state of health care among low income and minority workers is the major factor that is causing the increase in infant mortality in the U.S.?

• Are there economic factors behind the decision to have babies later in life, such as the inability of many families to survive economically without both parents out working full time, unable to support or care for children? Are the policies of the “pro-family values” Bush administration making the U.S. the wealthiest child-unfriendly country in history?

But, some would argue, the infant mortality rate in the U.S. is still relatively low, right?

Sure, when you consider the only countries besides Cuba that are doing better than we are: Australia, Austria, Brunei, Canada, Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Japan, Luxembourg, Malta, Netherlands, New Zealand, Norway, Portugal, San Marino, Singapore, Slovenia, Spain, Sweden, Switzerland, and the UK. (UNICEF and World Health Organization 2002 statistics.)

Not bad for us, the richest country in the world. We’re number 30! We’re number 30! Hurrah!

Emile Schepers is an activist in Chicago. He can be reached at