Pregnant Women in America Die More Often Than in Iran

The human lifespan is increasing and disease is decreasing, but a new study reveals some unsettling setbacks.
Photographer: Jamie Grill/Blend Images/Getty Images

The rate at which American women are dying from causes related to pregnancy or childbirth is on par with Iran, China, and some nations that made up the Soviet bloc. The difference is that in those countries, the prognosis is for improvement. In America, it’s not.

The disturbing trend is a counterpoint to global progress on healthy childbirth, according to a comprehensive new study. More than 275,000 women died worldwide last year in pregnancy, childbirth, or complications from it, most of the deaths preventable. In the U.S. these deaths have increased about 2.7 percent a year since 2000, to 26.4 deaths for every 100,000 live births, or 1,063 total, last year. (Iran has a lower rate and saw 281 maternal deaths in 2015).

This puts Americans in the same league as a handful of other developed nations that are also moving backwards, including Greece and Luxembourg. 

Terrible as this is, there’s plenty of good news in the 2015 Global Burden of Disease, Injuries, and Risk Factors study. The average human life span has increased by 10 years since 1980. A key driver has been decreased deaths from HIV/AIDS and malaria, which fell 33 percent and 37 percent respectively since 2005. And children are becoming less vulnerable to diseases that claim them before the age of five, as the world (despite a lack of progress on newborn mortality rates) halved the death rate of children younger than 5, to 5.8 million annually.

Children and women’s health are just two elements of this encyclopedic scientific review that explains the prevalence of 249 causes of death and 315 diseases and injuries documented globally since 1980. The main study was published on Thursday in the Lancet, with several thick accompanying analyses about women's health and childbirth, healthy life expectancy, behavioral and environmental risks, and child mortality. The work was led by the Institute for Health Metrics and Evaluation at the University of Washington and included 1,870 researchers in 127 countries. It was funded by the Bill & Melinda Gates Foundation.  

The numbers show where a world of improvement is needed. On top of its mom-care problem, the U.S. and many other nations face rising threats from drug abuse, obesity, and poor nutrition. 

The initiative’s overall goal was to build a data resource that enables comparisons of mortality data across many divides—sex, age, geography, time, and cause of death. It builds on editions from 2010 and 2013, which were in turn a reboot of a 1990 World Health Organization project. Universal measures of health, poverty, nutrition, energy, and well-being are becoming increasingly sought-after as the United Nations prods nations and multinational corporations to achieve its Sustainable Development Goals by 203o. 

The scientists emerged from the exercise with a way to compare national performance in health, through a tool they called a socio-demographic index. The team explains in an accompanying animation the need for this new public health index. Breaking the world generically into “developed”and “developing” nations was too superficial, and the World Bank’s conventional categorization places too much emphasis on national income alone.

Their socio-demographic index takes the temperature of countries and sub-national regions, based on per-capita income, education level, and fertility rate for each year from 1980 to 2015. Areas fall somewhere on a zero-to-one scale, with one representing the highest per capita income and education level, as well as the lowest fertility rate. The U.S., most of Europe, and Australia fall in the top 20 percent of the index; West Africa, East Africa, and Afghanistan land in the bottom 20 percent. The researchers use the index to generate an expectation about how each country might be doing, given its development level. Then they compare it with actual performance to gain a better sense of what's going right or wrong in every location.

The journal Nature on Wednesday published a separate study that can be seen as a companion to the voluminous work in the Lancet. Researchers at the Albert Einstein College of Medicine in New York reported that despite the much-welcome rise in human lifespans, they don’t seem to apply to people older than 100. No one has ever yet outlived Jeanne Calment of France, who died in 1997, at 122. “Our results strongly suggest that the maximum lifespan of humans is fixed and subject to natural constraints,” the authors write.

In other words, whichever of the 249 causes of death claims us, rest assured it will do so before we reach 125.

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