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 Message Boards » » Canada's health care system cracking Page [1]  
Prawn Star
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Hopefully this myth that Canada's health care system is superior to ours will be dispelled soon. The US healthcare system is flawed in a number of ways, but at least our government doesn't force people to wait months for surgery and outlaw private companies from providing alternatives.

Quote :
"Canada's Private Clinics Surge as Public System Falters

By CLIFFORD KRAUSS
VANCOUVER, British Columbia, Feb. 23 — The Cambie Surgery Center, Canada's most prominent private hospital, may be considered a rogue enterprise.

Accepting money from patients for operations they would otherwise receive free of charge in a public hospital is technically prohibited in this country, even in cases where patients would wait months or even years before receiving treatment.

But no one is about to arrest Dr. Brian Day, who is president and medical director of the center, or any of the 120 doctors who work there. Public hospitals are sending him growing numbers of patients they are too busy to treat, and his center is advertising that patients do not have to wait to replace their aching knees.

The country's publicly financed health insurance system — frequently described as the third rail of its political system and a core value of its national identity — is gradually breaking down. Private clinics are opening around the country by an estimated one a week, and private insurance companies are about to find a gold mine.

Canada remains the only industrialized country that outlaws privately financed purchases of core medical services. Prime Minister Stephen Harper and other politicians remain reluctant to openly propose sweeping changes even though costs for the national and provincial governments are exploding and some cancer patients are waiting months for diagnostic tests and treatment.

But a Supreme Court ruling last June — it found that a Quebec provincial ban on private health insurance was unconstitutional when patients were suffering and even dying on waiting lists — appears to have become a turning point for the entire country.

"The prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services," the court ruled.

In response, the Quebec premier, Jean Charest, proposed this month to allow private hospitals to subcontract hip, knee and cataract surgery to private clinics when patients are unable to be treated quickly enough under the public system. The premiers of British Columbia and Alberta have suggested they will go much further to encourage private health services and insurance in legislation they plan to propose in the next few months.

Private doctors across the country are not waiting for changes in the law, figuring provincial governments will not try to stop them only to face more test cases in the Supreme Court.

While proponents of private clinics say they will shorten waiting lists and quicken service at public institutions, critics warn that they will drain the public system of doctors and nurses. Canada has a national doctor shortage already, with 1.4 million people in the province of Ontario alone without the services of a family doctor.

"If anesthetists go to work in a private clinic," Manitoba's health minister, Tim Sale, argued recently, "the work that they were doing in the public sector is spread among fewer and fewer people."

But most Canadians agree that current wait times are not acceptable.

The median wait time between a referral by a family doctor and an appointment with a specialist has increased to 8.3 weeks last year from 3.7 weeks in 1993, according to a recent study by The Fraser Institute, a conservative research group. Meanwhile the median wait between an appointment with a specialist and treatment has increased to 9.4 weeks from 5.6 weeks over the same period.

Average wait times between referral by a family doctor and treatment range from 5.5 weeks for oncology to 40 weeks for orthopedic surgery, according to the study.

Last December, provincial health ministers unveiled new targets for cutting wait times, including four weeks for radiation therapy for cancer patients beginning when doctors consider them ready for treatment and 26 weeks for hip replacements.


But few experts think that will stop the trend toward privatization.

Dr. Day's hospital here opened in 1996 with 30 doctors and three operating rooms, treating mostly police officers, members of the military and worker's compensation clients, who are still allowed to seek treatment outside the public insurance system. It took several years to turn a profit.

Today the center is twice its original size and has yearly revenue of more than $8 million, mostly from perfectly legal procedures.

Over the last 18 months, the hospital has been under contract by overburdened local hospitals to perform knee, spine and gynecological operations on more than 1,000 patients.
"




http://www.nytimes.com/2006/02/28/international/americas/28canada.html?pagewanted=1&ei=5070&en=cb1fc68347405791&ex=1145505600[link]http://www.nytimes.com/2006/02/28/international/americas/28canada.html?pagewanted=1&ei=5070&en=cb1fc68347405791&ex=1145505600[/link]



[Edited on April 18, 2006 at 8:31 PM. Reason : w]

4/18/2006 8:29:22 PM

Republican18
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blame canada

4/18/2006 8:33:54 PM

RevoltNow
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Canada
Indicator Value Latest Year
Infant mortality rate, both sexes (per 1000 live births) (?) 5.1 2000
Life expectancy at birth (years) total population (?) 80.0 2003

United States of America
Indicator Value Latest Year
Infant mortality rate, both sexes (per 1000 live births) (?) 7.2 2000
Life expectancy at birth (years) total population (?) 77. 2003

source World Health Organization
what a myth it is.

4/18/2006 8:51:52 PM

panthersny
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thank god we never got hiliary care

4/18/2006 8:55:05 PM

LoneSnark
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^^ Not to diss your statistics but a larger percentage of the US population is made up of poor immigrants and poor minorities (blacks) all of which drag down our scores.

That said, I have no doubt Canada's statistics are better than ours, just not by much. A purely socialized health-care system is preferrable to a bloated mixed system, such as exists in the U.S.

[Edited on April 18, 2006 at 8:57 PM. Reason : ^]

4/18/2006 8:57:27 PM

RevoltNow
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Quote :
"In 2004, the United States spent 16 percent of its gross domestic product (GDP) on health care. It is projected that the percentage will reach 20 percent in the next decade (2).

Although nearly 46 million Americans are uninsured, the United States spends more on health care than other industrialized nations, and those countries provide health insurance to all their citizens. (4)

Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France, according to the Organization for Economic Cooperation and Development. (5)
"

http://www.nchc.org/facts/cost.shtml
(2)Borger, C., et al., "Health Spending Projections Through 2015: Changes on the Horizon," Health Affairs Web Exclusive W61: 22 February 2006.
(4)California Health Care Foundation. Health Care Costs 101 -- 2005. 02 March 2005.
(5)Pear, R.. "U.S. Health Care Spending Reaches All-Time High: 15% of GDP." The New York Times, 9 January 2004, 3.

4/18/2006 8:59:58 PM

Prawn Star
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with respect to mortality rates, the Canadian population is demographically different from America’s in important ways. The average age of the Canadian population is lower than that of the United States. There is less obesity in Canada, fewer premature births, fewer victims of assault and attempted homicide. Canadians also drive fewer miles per year than Americans. The racial makeup of the countries are different, with a higher proportion of whites and lower proportion of blacks in Canada. These differences all skew life expectancy in Canada's favor.

if you want to look a little deeper, try this study on Northwestern US states and Western Canadian provinces that have similar ethnic makeup (as different ethnic groups get cancer at different rates in the first place) and other characteristics for cancer fatality rates. See these tables and compare Colorado, Idaho, and Utah with the Canadian Western provinces. For instance, Utah and Alberta have almost identical cancer incidence rates at 307 and 312.8 respectively but the male case fatality rates are .3456 and .43798 respectively. British Columbia scores lowest in case fatality rates of all Canadian provinces and yet it is worse than almost half the US states.


http://www.canceradvocacy.ca/pages/stats-mortalality-fatality.htm

[Edited on April 18, 2006 at 9:01 PM. Reason : 2]

4/18/2006 9:01:00 PM

RevoltNow
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2004 US immigrant population
34 million http://www.cis.org/articles/2004/back1204release.html
total
about 290 million
therefore around 12%

http://www40.statcan.ca/l01/cst01/demo46a.htm
canada had 16-18% from 91 to 01

4/18/2006 9:07:29 PM

Prawn Star
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^I'm not even sure what that is supposed to indicate, but Canada's racial makeup clearly affects life expectancy. To argue otherwise would be foolish.

^^^Yes, we spend a shit-ton on our health. But at least we don't die waiting to get cancer treatment like many in Canada's bullshit system.

Also, a very significant portion of our added health expenditures go towards drugs. We subsidize R&D for drugs that benifit the whole world. If we negotiated cut-rate prices for drugs like other countries, R&D would plummet and worldwide health would be negatively affected.

[Edited on April 18, 2006 at 9:12 PM. Reason : 2]

4/18/2006 9:08:17 PM

RevoltNow
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http://www.canceradvocacy.ca/pages/stats-mortality-rates-all-sites.htm

in all cancer cases when you rank the us and canadian provinces
first is utah
SIXTH is British Columbia

8 of 10 canadian provinces listed are in the top 36

4/18/2006 9:12:07 PM

RevoltNow
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yes yes
we have great doctors and the best companies in the world

but we get shit for our money. its fucking embarrassing (sp?) that we spend almost twice canada and have similar numbers. and that is with canada being a relatively high spender.

4/18/2006 9:13:45 PM

Prawn Star
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^^it figures, considering that incidence rates are MUCH higher in the US.

We are talking about health care treatment here, not population demographics. Correspondingly, any cancer mortality rates which don't factor in the incidence rates are meaningless. Which is why my original link is relevant and yours is not.

[Edited on April 18, 2006 at 9:17 PM. Reason : 2]

4/18/2006 9:16:50 PM

Prawn Star
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Quote :
"its fucking embarrassing (sp?) that we spend almost twice canada and have similar numbers."


My point is that our care is better than Canada's, and that if you actually delve into the statistics with an open mind it's obvious. We don't have ridiculous waiting lines for specialists and we don't have regulations that outlaw people from buying the best medical care possible.

Its silly to just look at how much we spend and how long we live as litmus tests for health care.

Quote :
" purely socialized health-care system is preferrable to a bloated mixed system, such as exists in the U.S."


No, it's not. The best health care systems are mixed systems, such as those employed in many European countries. Canada's purely socialized system is broken, and my original link is proof of that.

[Edited on April 18, 2006 at 9:24 PM. Reason : 2]

4/18/2006 9:21:32 PM

RevoltNow
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and my point is that if you are one of the 46 million americans who are uninsured you are fucked no matter what.

4/18/2006 9:23:06 PM

Id hit it
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Quote :
" but Canada's racial makeup clearly affects life expectancy. "


Yeah, i'm calling bullshit.

Americas poor healthcare system which keeps minorities in a state of poor health, because of having to worry about money when dealing with helath care, is responsible for the lower life expectancy of minorities in this country. To think otherwise is simply showing complete ignorance of facts.

4/18/2006 9:28:07 PM

Prawn Star
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^facts show that blacks have shorter life expectancies across all income and insurance demographics. I am not gonna bother finding these facts. Its common knowledge to anyone in the medical profession, like the fact that women live longer than men.

^^eh, not so much. It's not like they get denied emergency services.

And some people like spending their money on other things rather than padding the margins of HMOs.

Besides, Canada has a significant proportion of uninsured members as well. Because of doctor shortages, many Canadians, wealthy and poor, cannot find a family doctor and correspondingly have no coverage under their "universal" system.

[Edited on April 18, 2006 at 9:29 PM. Reason : 2]

[Edited on April 18, 2006 at 9:31 PM. Reason : 2]

4/18/2006 9:29:14 PM

RevoltNow
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emergency room does not equal medical care

since you are so worried about cancer, how does an emergency room help with that?

4/18/2006 9:30:34 PM

Prawn Star
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actually, the emergency room is a definite form of medical care

And uninsured people with cancer just have to be accountable for their decisions in life, like the rest of us.

4/18/2006 9:33:48 PM

Id hit it
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Quote :
" ^^eh, not so much. It's not like they get denied emergency services. "


Emergencies are not going to affect life expectancy that much, although it does to a degree, considering most minorities probablly live in an area that has poor emergency services and low income lifestyles frequently result in more dangerous lifes, i should know, i've been there.

No, we're talking about people simply not living as long because they recieve poor preventive health care. Why go for regular check-ups when you've got to pay for them and nothing is wrong? Because it might show indicators, that can be used to prevent future ailments.

So yeah....

4/18/2006 9:35:44 PM

RevoltNow
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the poor choose to be poor?


Ignore the actual article, since its biased, but the study that the article is based upon is not.
http://www.misterc.ca/healthcare_canada_vs_usa.htm
Quote :
"
In a study conducted jointly by Statistics Canada and the U.S. National Center for Health Statistics in 2002-2003, 3,505 Canadians and 5,183 Americans over the age of 18 were interviewed about the health services they receive. Below are selected results.
"


I was looking for that study, but had problems, im going to keep looking.
But, the overall conclusion from the information is that more canadians smoke and choose to do stuff like not go to a dentist, yet receive better care.
feel free to argue about facts vs opinion, i just thought that this stuff was interesting

4/18/2006 9:38:38 PM

Id hit it
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Quote :
"And uninsured people with cancer just have to be accountable for their decisions in life, like the rest of us."


So growing up in a lowincome area that couldn't afford to clean the asbestos out of its school should just... be accountable for it? thats fucking stupid

[Edited on April 18, 2006 at 9:41 PM. Reason : .]

4/18/2006 9:40:00 PM

Id hit it
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i'd also like to add that canadians smoke more pot than americans do... .just wanted to throw that out there...

4/18/2006 9:41:39 PM

RevoltNow
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Relation between income inequality and mortality in Canada and in the United States: cross sectional assessment using census data and vital statistics

Nancy A Ross, research analyst, health analysis and modelling group, a Michael C Wolfson, director general, analysis and development branch, a James R Dunn, research associate, b Jean-Marie Berthelot, manager, health analysis and modelling group, a George A Kaplan, professor and chair, c John W Lynch, assistant professor. c

a Statistics Canada, Ottawa, ON, Canada K1A 0T6, b Centre for Health Services and Policy Research, Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, Canada V6T 1Z3, c School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA

Quote :
"Objective: To compare the relation between mortality and income inequality in Canada with that in the United States.
Design: The degree of income inequality, defined as the percentage of total household income received by the less well off 50% of households, was calculated and these measures were examined in relation to all cause mortality, grouped by and adjusted for age.
Setting: The 10 Canadian provinces, the 50 US states, and 53 Canadian and 282 US metropolitan areas.
Results: Canadian provinces and metropolitan areas generally had both lower income inequality and lower mortality than US states and metropolitan areas. In age grouped regression models that combined Canadian and US metropolitan areas, income inequality was a significant explanatory variable for all age groupings except for elderly people. The effect was largest for working age populations, in which a hypothetical 1% increase in the share of income to the poorer half of households would reduce mortality by 21 deaths per 100 000. Within Canada, however, income inequality was not significantly associated with mortality.
Conclusions: Canada seems to counter the increasingly noted association at the societal level between income inequality and mortality. The lack of a significant association between income inequality and mortality in Canada may indicate that the effects of income inequality on health are not automatic and may be blunted by the different ways in which social and economic resources are distributed in Canada and in the United States. "

4/18/2006 9:46:07 PM

Id hit it
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^^ [smack]

4/18/2006 9:48:53 PM

Prawn Star
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^^if that study was "race-blind", then it was seriously flawed. Likewise, if it didn't factor in higher homicide, assault and drug addiction rates of the US that are concentrated in poor urban areas, then the study is flawed and inconclusive.

from your link above
Quote :
"42 per cent of Americans and 39 per cent of Canadians describe the quality of care in their respective countries as "excellent." At the other end of the spectrum, 12 per cent of Americans and 15 per cent of Canadians rate health care as "fair" or "poor." (The rest, 46 per cent in both countries, ranked services as "good.")
"

I find it pretty interesting that the "universal" health coverage that many Canadians and liberals brag about is not even as popular within Canada as our oft-criticized system is over here. Maybe some people really hate waiting months for specialized care with no alternatives.

Quote :
"So growing up in a lowincome area that couldn't afford to clean the asbestos out of its school should just... be accountable for it? thats fucking stupid"


No, your example is fucking stupid. Kids in low income areas (presumably from low income families) qualify for medicaid. If you are talking about adults who were exposed to asbestos in public schools as children, then they have the right to sue the school system for any and all medical costs, lost work and emotional distress associated with the exposure.

It's really not very hard to get health insurance in this country. If you can work, you can find a job that offers it. Wal-Mart and most grocery stores offer insurance benefits. If you can't work, then you probably qualify for some type of state or federal coverage. In the real world, the majority of people who are not insured have chosen not to insure themselves, in one way or another.

[Edited on April 19, 2006 at 12:17 AM. Reason : 2]

4/19/2006 12:08:04 AM

moron
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Quote :
"^facts show that blacks have shorter life expectancies across all income and insurance demographics. I am not gonna bother finding these facts. Its common knowledge to anyone in the medical profession, like the fact that women live longer than men."


Why is that even relevant? It's like you're implying that blacks and poors shouldn't be counted.

[Edited on April 19, 2006 at 12:15 AM. Reason : ]

4/19/2006 12:15:17 AM

Prawn Star
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I'm saying that when studying health care, you can't look at life expectancy rates between our 2 countries without factoring in demographic differences such as race and crime. They skew the data.

4/19/2006 12:20:54 AM

moron
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The do skew the data, but rightfully so. Blacks are and have been an integral part of society, and their health does reflect on the health care system as a whole, as well as other parts of society.

It's disingenuous to completely ignore that statistic.

Statistics of wait-time to see a specialist doesn't show the whole picture either. Does the Canadian system just work by first-come-first-serve, or is there a priority to the order of waiting? Can patients jump up in priority?

4/19/2006 12:27:31 AM

Kris
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Quote :
"Not to diss your statistics but a larger percentage of the US population is made up of poor immigrants and poor minorities (blacks) all of which drag down our scores."


Ok, I'll play that, how do you explain this then?

United States - 6.43
Cuba - 6.22

2006 est.
http://www.cia.gov/cia/publications/factbook/rankorder/2091rank.html

4/19/2006 12:33:22 AM

RevoltNow
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anything within 3 percentage points for opinion is unimportant.
even if we say that that amount matters we are paying almost double for 3 percentage points "better" care? that doesnt seem absurd to you?

i would say that crime is a product of the economic inequality that was mentioned, meaning that crime and poor healthcare are both symptoms of something else.
as for race, how exactly does race affect this? are blacks unhealthy because they are racially inferior? NO. they do however have a higher level of poverty, because of lots of history, but how this poverty plays in healthcare is what the study was trying to establish. if our system gave every american who was willing to seek out care an equal chance of receiving quality healthcare there would be little to no correlation between quality of care and wealth. HOWEVER, there is a correlation. in canada, this correlation does not exist.

4/19/2006 12:36:00 AM

Waluigi
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canada has been cracking lately in general...but thats due more to corruption and division than anything. plus, socialized heathcare should be on a provincial/state level in order to be more effective.

4/19/2006 12:36:14 AM

Prawn Star
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^^^^I am talking about factoring for race, meaning comparing the countries as if racial proportions were the same.

^^^I'm gonna play the race card

Believe it or not, hispanics have a lower infant mortality rate than whites in the US. The statistics show that race plays a clear factor in infant mortality rates. If you compare hispanics to hispanics, the US has a lower rate. Which is surprising considering the high rate of uninsured hispanic immigrants in this country.



from here

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5115a4.htm


[Edited on April 19, 2006 at 12:45 AM. Reason : 2]

4/19/2006 12:44:40 AM

RevoltNow
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we get it. you hate black people.

4/19/2006 12:46:06 AM

Kris
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Quote :
"I'm gonna play the race card"


I still believe your judgement is skewed as blacks tend to constitute the poorer part of the population, I'd say this explains why they have higher infant mortality rates moreso than to say the are less likely to live simply because of the color of their skin.

4/19/2006 1:04:35 AM

Prawn Star
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^the statistics are way too correlated to be the result of socioeconomic differences between races. If that were the case, then hispanic infant mortality rates should logically fall a lot closer to black rates.

^^aha

right. I guess its predictable that I'd be called a racist for pointing out obvious, documented racial differences. But the statistics don't lie, and as I stated before, men have a significantly shorter life expectancy than women within every demographic, rich or poor, insured or uninsured. The same is true for blacks versus whites. And this is true for any large random sample of people in any country.

Therefore it is obvious that the higher proportion of blacks in America versus Canada skews the data. Its called Simpson's paradox. If you have no idea what I'm talking about, then try a google search.

Prove me wrong. I'm begging you. Otherwise your "racism" accusations hold no merit at all.

[Edited on April 19, 2006 at 1:08 AM. Reason : 2]

4/19/2006 1:05:37 AM

Kris
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Quote :
"the statistics are way too correlated to be the result of socioeconomic differences between races. If that were the case, then hispanic infant mortality rates should logically fall a lot closer to black rates."


I'd have to question how these statistics were taken in relations to the legality of immigrants.

4/19/2006 1:10:18 AM

RevoltNow
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i looked at that study, and the one that it cited that sought to control for socio-economic status by only looking at college graduates, and neither seemed to control for income levels or anything else. just controlling for whether or not the person is a college graduate does not control for income disparity between the races.

both studies talked about low birth weights.
from unicef:
In the industrialized world, cigarette smoking during pregnancy is the leading cause of low birthweight.
In the developing world, low birthweight stems primarily from the mother's poor health and nutrition. Three factors have most impact: the mother's poor nutritional status before conception, short stature (due mostly to undernutrition and infections during her childhood), and poor nutrition during the pregnancy.

more blacks smoke cigarettes. there is economic disparities between races, even among college graduates. that blacks have higher levels of infant mortality does not mean that race is the cause of this.

4/19/2006 1:25:04 AM

Prawn Star
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Quote :
"more blacks smoke cigarettes. "


You sure about that, chief? Thats not my understanding.

here ya go. (from the link)

And of course you were right that poverty plays a significant role in higher infant mortality rates for blacks. But it doesn't explain all of the discrepancies.

Quote :
"Editorial Note:
This report highlights considerable geographic, racial, and ethnic differences in IMRs in the largest U.S. cities. Because urban communities are targets for many local, state, and federal initiatives, reporting and comparing city-specific IMRs for understanding city-level differences in child health is important.

Previous studies have examined factors related to black-white disparities in infant mortality. Infants with very low birthweight account for approximately two thirds of the black-white gap in infant mortality (6). Preterm delivery is associated with the deaths of infants with very low birthweight, demonstrating the need to reduce preterm births, particularly among black infants. Racial disparity in IMRs has not been explained fully by differences in socioeconomic status. Black infants born to college-educated parents have higher IMRs than white infants born to parents of similar educational background; this difference is attributed to a higher rate of very low birthweight (7). Education of the mother does not confer the same level of protection against infant mortality among black women as it does among white women, suggesting that a complex interaction of social, environmental, and biologic factors that are experienced uniquely by black women might account for the disparity. Racial segregation is an important macrolevel predictor of greater black-white infant mortality differences in 38 U.S. metropolitan statistical areas, independent of differences in median income (8).

Despite higher poverty and lower education rates, Hispanic infants have higher birthweights and their IMRs approximate those of white infants. This finding is consistent with previous studies (9) and contradicts common assumptions about poor, underserved minority groups. Cultural practices, family support, selective migration, diet, and genetic heritage are possible contributing factors (9). Furthermore, U.S. Hispanics are a heterogeneous group, and IMRs are higher among Puerto Rican infants (10). In Philadelphia, 79% of Hispanic births were born to Puerto Rican mothers, possibly explaining the higher IMR in that city.

"


[Edited on April 19, 2006 at 1:29 AM. Reason : 2]

4/19/2006 1:26:12 AM

RevoltNow
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U.S. mortality rates among infants, by race/ethnicity of mother, from 1980 to 2001 (line graph): Deaths per 1,000 live births, 2001—Black, 14.2; White, 5.7; All races*, 6.9. Trends have decreased dramatically among all groups.

so in 2001 in america whites had an infant mortality rate of 5.7 per 1000, and in 2000 all canadians had a rate of 5.1.
ITS NOT RACE.

4/19/2006 1:27:35 AM

RevoltNow
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From source 8 of the article you cited:
they measured segregation levels, economic disparity and infant mortality rates of blacks and whites in 38 cities.
guess what, the segregation index showed independent correlation with infant mortality rates.
there was almost no correlation between amount of houses headed by females.
there was however almost perfect correlation between segregation index and infant mortality. and a high level of correlation between economic disparity and infant mortality.
the authors were unwilling to say there was causation, but to say that blacks have higher levels of infant mortality because they are black is idiotic.

4/19/2006 1:39:29 AM

Prawn Star
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Quote :
"Black infants born to college-educated parents have higher IMRs than white infants born to parents of similar educational background; this difference is attributed to a higher rate of very low birthweight (7). Education of the mother does not confer the same level of protection against infant mortality among black women as it does among white women, suggesting that a complex interaction of social, environmental, and biologic factors that are experienced uniquely by black women might account for the disparity."


wow, the CDC is idiotic then

[Edited on April 19, 2006 at 1:55 AM. Reason : 2]

4/19/2006 1:54:47 AM

Kris
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If I recall, black women are also MUCH more likely to use drugs during pregnancy.

4/19/2006 1:58:08 AM

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