Where it is the case that a government doesn’t provide for the needs of all its people in an equitable sense, it has failed to create a system that is optimal for the fair coexistence of its constituents. Of the wide array of problems that proliferate the society of the United States, those which arise regarding access and quality of medical care can be some of the most egregious. In the United States, which has a medical industry funded to extreme proportions, the problem of infant mortality is one of the most exacerbated within “first world” countries like itself. This is represented by a national average of 5.8 deaths per every 1,000 people born, with much higher rates being exhibited by historically marginalized populations. The purpose of this article is to present a modest amount of information in order to spark inquiry into the problem of infant mortality, with particular emphasis on the Saint Louis region. The issues outlined here are not exclusive to the Saint Louis community, rather they present a huge obstacle to many populations around the United States. In examining one particular community, my hope is for more people to take an interest in where the healthcare system breaks down for particularly at risk, marginalized people.
With a healthcare system as well funded as that of the United States, it is bewildering to think about the immense rate of infant mortality within its population. As some people attribute this to the dysfunctional approach to providing care and education, this article will address the problems which arise even before a person enters a medical practice. To begin, the problem at hand is one that affects various communities in very different ways. In the Saint Louis region, the infant mortality rate within the city remains largely unaltered from previous years even though the county’s average has begun to decline slightly. When thinking about this particular issue there are many moving parts at play, none of which are unforeseeable or unsolvable, but merely unremedied. One such issue is that medical care providers within regions of Saint Louis City are nearly nonexistent or very hard to access, therefore making it difficult to obtain prenatal care. In addition, transport can create an immense obstacle when care is so far away. Health insurance plays a role in the problem: network doctors often are located far out into the county which makes it extremely difficult to make appointments without personal transportation.
Another component of this problem is the disproportional concentration of medical services in higher-income as opposed to lower-income areas. For example, lower-income regions of Saint Louis City continue to have incredibly high amounts of infant mortality. Within the city, approximately 10.5 out of 1,000 infants die before they reach the end of their first year of life, compared to six deaths out of 1,000 infants in Saint Louis county. This difference is potentially indicative of a number of different factors. According to the CDC’s most recent inquiry into the issue of infant mortality rates, they found that these rates varied largely with race. For African Americans, the infant mortality rate in the United States was shown to be an astounding 11.4 out of 1,000 infants. Further, according to St. Louis Public Radio, African American infants are three times more likely to die than white infants, despite the fact that African Americans make up a substantial portion of the population of Saint Louis.
While access to care constitutes a large portion of the problem, it is also the case that factors such as low income, poor quality insurance, and lack of prenatal care are to blame as well. Ultimately, these factors add up to make it very difficult for mothers to have a healthy pregnancy and pre-pregnancy period where they can improve the likelihood of better health for their future child. Indeed, the importance of these periods of time has long been advocated for by the local organization Generate Health which, amongst other objectives, seeks to reduce infant mortality and improve health outcomes in the Saint Louis region. Generate Health states that the issue of infant mortality deprives the Saint Louis community of 15 classrooms worth of kids every single year.
It should be clear at this point that these high rates of infant mortality represent an injustice and harm which has been perpetuated by society in multiple ways, including inaction. In order to act, one must gain enough knowledge about the situation in order to provide an amply successful solution to the problem. These issues will not change without the involvement and engagement of not only the communities which they affect most, but the society as a whole. If we accept as problems high rates of infant mortality amongst marginalized populations and families being deprived of their children, then we as a society are obligated to address these issues. I sincerely hope that you will consider learning more about this particular issue and sharing what you learn with others in order to form a broader consensus that something must be done. Please do share in the work that needs to be done to make the United States function better for everyone.