The United States likes to think of itself as enlightened. We do a nice job of talking the talk when it comes to children. But we’re hopelessly lost on the walk. Our cognitive dissonance is acute, our sins of omission numerous.
For starters, we’re the only nation, besides Somalia, that hasn’t gotten around to ratifying the . Adopted by the U.N. General Assembly in November of 1989, it is “the first international treaty”—as Amnesty International points out, in boldface, on its web site—“to guarantee civil and political rights as well as economic, social, and cultural rights.” We’ve also been rapped on the knuckles by Human Rights Watch, which lambasted the U.S. for with its lack of paid leave and work-family supports.
We keep stumbling over that pesky question of government intrusion into the private realm of the family. Of course, some among us have no problem injecting themselves into the very private parts of the women who bear those children. But support for said progeny’s early development and education? You’re on your own, baby.
All of the above is playing out in the battle over the Affordable Care Act, or “Obamacare” (the name by which the President’s signature social policy has come to be known, for better and for worse). For the first time, as Eduardo Porter bluntly notes in “New Front in the Fight with Infant Mortality,” pregnant women across the socio-economic spectrum “will have guaranteed access to health insurance offering .” His piece was better than an antidepressant. How refreshing to see the intricacies of prenatal care and family policy laid bare in the business section of the New York Times.
Porter offers up a little legislative history of the health care bill, noting the victory of the Senate Finance Committee over Arizona Senator Jon Kyl, who opposed such a standard, declaring that he didn’t need maternity care on his insurance policy, and inclusion would up the price. A mere pretext for his real objection, of course: that Big Brother was laying his hand on the cradle of the American child. But then we get to the main event: the “drawbacks inherent in the United States’ model of relatively low taxes and modest government, leaving more social outcomes to the sway of market forces.” Here’s Porter’s assessment, highlighting yet another transgression of our enlightened nation:
The benefit may seem narrow. But it offers the best opportunity in a generation to tackle one of the United States’s most notorious stigmas: an intractably high infant mortality rate that hardly fits one of the richest most technologically advanced nations on earth. If it succeeds, it could provide Americans with an alternative view of how government can serve society.
Apparently, our infant mortality rate—6.1 babies out of every 1,000 —puts us at the bottom of the chart of members of the Organization for Economic Cooperation and Development (OECD), besting only Mexico, Chile, and Turkey.
I checked in with , an organization founded in 2003 by pediatrician George Askew, now the Chief Medical Officer at the U.S. Administration for Children and Families. Liz Isakson and Dina Lieser, who have recently resurrected the advocacy group, are based in New York City, where the infant mortality rate declined steadily, overall, from 2002 to 2011. Dig deeper, however, and the racial, ethnic, and economic disparities rear their ugly heads. From 2009 to 2011, Brownsville and East New York, two of Brooklyn’s most , clocked in, respectively, with rates of 9.2 and 8.4; central Harlem at 8.5; and Morrisania, the historical name for the South Bronx, at 7.7 deaths per 1,000 infants.
“Disparities in health, school, and life success begin well before birth,” said Lieser. “Any chance we have as a nation to set our children on the right trajectory includes meaningful attention to and investment in the prenatal period. This is simply taking what we know, and making smarter choices.”
