OTTAWA – Canada continues to have one of the highest infant mortality rates in the developed world, a trend that has held since the 1990s, according to a new study.
Canada recorded five deaths for every 1,000 live births in 2006, placing it 15th out of 17 peer countries, according to a report card of health indicators released by the Conference Board of Canada Monday.
While Canada has improved its infant mortality rate since the 1960s, it has been unable to match the success of the majority of its peers which have managed to improve at a much more rapid pace.
Peer countries are members of the Organization for Economic Co-operation and Development and include the U.S., U.K., Japan, Switzerland, Denmark, Finland, France, Australia, Austria, Belgium, Germany, Ireland, Italy, Netherlands, Norway and Sweden.
"(Infant mortality) is an indicator that is quite important," said Gabriela Prada, director health policy for the Conference Board. "It gives you a sense of the well-being of a society and it has a lot to do with health equality and quality of life."
Prada said Canada’s relatively high infant mortality rate – the rate at which infants die before their first birthday – may be due to a high number of premature births and fertility programs increasing the number of multiple births, along with a variety of socio-economic and environmental factors.
"The fact that Canada does not seem able to break below the rate of five deaths per 1,000 live births, while 14 peer countries already have, suggests that further attention must be paid to better understanding international differences in infant mortality rates – whether they are due to methodological or socioeconomic factors, or both," the study said.
One of Canada’s foremost experts on infant mortality rates, however, disputes the dire picture painted by the Conference Board’s international rankings and argues that they are comparing "apples and oranges."
University of British Columbia Prof. K.S. Joseph said Canada follows the World Health Organization’s definition for live births which includes any baby that manages to take a breath, even if the prospects for survival are slim. Some countries, like Sweden, do not register births unless they have a reasonable chance of survival, he said.
In Japan, there have been questions over the categorizing of stillbirths.
"In other countries, in Europe, Scandinavia, they have a much pragmatic system," said Joseph, of UBC’s department of obstetrics and gynecology. "Why should you register babies that have no chance of living?"
Joseph said that babies weighing under 1,000 grams make up 40 per cent of infant mortalities in Canada.
A breakdown of the infant mortality rate in Canada, however, does reveal areas of concern in the country, said Joseph, who co-authored a study published in January that found regional disparities in infant mortality rates within the country "increased" during the federal budget cuts of the Liberal government in the 1990s.
Joseph also said infant mortality rates are much higher among First Nations, Inuit and Metis population and among the poor.
"We are doing reasonably well, but there are some vulnerable populations where we could do better," he said.
According to the Conference Board’s study, Canada tied with the U.K. on the infant mortality rate ranking, placing ahead of the U.S.
Japan, Finland, and Sweden recorded infant mortality rates of fewer than three deaths per 1,000 live births, said the study.
Canada ranked fifth in 1990 with almost seven deaths per 1,000 live births and it has lost ground ever since, the study said.
Canada ranked 10th in overall health indicators, according to the study, which was based on data from 2006. The U.S. came in last.
Canada also scored low when it came to death due to diabetes, placing 14th, and death to due to musculoskeletal diseases, placing 10th, the study found.
"Increasing levels of mortality due to diabetes should be raising alarm bells among policy-makers and the public," said Prada. "As the population ages, the burden from chronic diseases will only grow."
Prada said the quality of a country’s health-care system was responsible for about 25 per cent of the level of overall health indicators, while socio-economic determinants like housing, education and social support made up about 50 per cent and a country’s green pool and other marginal factors made up the rest.
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