Master Class

Neighbors a World Apart


Infant mortality is one of the dominant measures by which a nation's health is judged. Many factors contribute to the number of babies who survive in a given country, making infant mortality a rather unrefined gauge of overall health. Yet it has been accepted worldwide as a generally fair and realistic reflection of national health.

Leaders in the medical community and government have long recognized that the United States has unacceptably high infant mortality in comparison with other nations. I served, in fact, on the Department of Health and Human Services' Secretary's Committee on Infant Mortality under President George H.W. Bush, as part of a major effort to reduce by half our infant mortality. We still have not succeeded, despite concerted efforts.

Because this is a complex issue that will be solved only by using multiple strategies, we may do well to learn from other countries' successes. The Scandinavian countries, which boast very low infant mortality, have homogeneous populations that are difficult to compare with our own. But right next door is Canada, a country with an increasingly diverse population that may serve as a more analogous example of how programs can work to reduce infant mortality.

For a commentary on this important issue, we turn to C. Robin Walker, M.D., Ch.B., president of the Canadian Paediatric Society and professor of pediatrics at the University of Ottawa. He has studied infant mortality as an international issue, publishing on such topics as population-based approaches to prevention of preterm birth, an important contributor to infant mortality.

We hope his thoughts will provide fresh insight into a very important health measure that we continue to try to improve.

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