A Scold for Holland, Too (Among Other Things)

As part of a few international communities on the "interwebs," I routinely have the opportunity to hear people talking smack about my first country, the US. The US in the international community is like the kid with crutches, braces, and red hair who is loved by the teachers and has nothing to say to other children: an easy target. As Anthony Bourdain recently mentioned on No Reservations, "I get tired of my country being the bad example."

Having left said country for one more suited to my own nature (yayy Holland), I'm often one of the bashers and as anyone who's read my blogs knows, I'm a big fan of the Netherlands. (I'm looking for the +1 button on the Dam.)

So it was with astonishment that I listened to a self-professed intelligent Spanish woman explain how all the problems in Spain, Italy and Greece are the result of retirees from the north. [In case you're American and haven't been informed, Greece, Spain and Italy are having financial problems which have been brought to light by the EU's refusal to allow its member countries to rack up and continue to sustain huge national debts.]

Since my conversation with the Spanish woman left me completely baffled, it was up to my Dutch friend to explain to me that the southern countries (read: warm), as a favorite retirement location for English, Dutch, German, etc. old people, have taken to blaming their multi-billion euro debts on the fact that people from the north retire there. Apparently, these retirees are rumored in those countries to show up penniless and without means of support on their doorsteps and then of course the poor southern countries have to spend all their money on feeding and housing the poor old people.

When it was mentioned to the Spanish woman that all of the northern countries (Holland, Belgium, Germany, Sweden, Switzerland, Denmark, etc. all have a history of similar social programs) continue to pay retirement to and to insure their retirees no matter where they wander off to live, she simply said with complete confidence, "No they don't." She defended this statement as being her opinion. But enough about her and her lack of logic; she's not the point.

The point is that it cuts both ways. Yes this is me taking Holland to task. As ridiculous as you know such assertions by the populace of the south to be, the assertions by a handful of idiots (with their accompanying nods from the TV-watchers in the bars) that every ill in Holland is caused by the "massive" influx of population from the east is equally ignorant and lacking any basis in fact. (In fact the hiccups of all the European economies can largely be traced back to those wonderful worthless loans that the American banks bundled and sold as ordinary securities, ensuring that when they went down and started an economic crisis it will cost no less than a decade to fully recover from, they would take the rest of the world down with them. And their ability to do that can be traced back to trickle-down economics and the policies of deregulation. Why would we need to keep an eye on people who hold the country's welfare in their greedy little hands? How quickly we forget.)

But back to my story! The US came to a point in its history where there were irreconcilable disagreements over the policies and practices of the north and the south. They settled it at gunpoint. Europe won't do that, as membership in the European Union is a privilege, but it does cause concern about the new Chinese neighbors that northern Europe's going to have if it plays out without resolution and China eventually forecloses on its loans.

Don't laugh, Americans: The Chinese own $1 trillion of the US too.

The Vaccccciiiiiiiines - It's the Vaccines!

Dr. Mercola wants us to know that the US is killing our children by forcing too many vaccines on them. From Mercola's page:

"In 1960, America ranked 12th in infant mortality among all nations of the world. In 2005, we had fallen to number 30. Today in America, there are more premature babies than ever before and more full term babies die before their first birthday than in most European countries.

"Doctors give American babies 26 doses of vaccines before age one, which is twice as many vaccinations as babies in Sweden and Japan get. Is it really just a "coincidence" that the infant mortality rate is twice as high in America compared to Sweden and Japan, where half as many vaccinations are given to very young babies?" [boldface added]

Well that there is what I call one damn fine question!

Assuming for Dr. Mercola's sake that those were reverse rankings, and that the US in 1960 had the 12th lowest infant mortality rate, where does the US stand today? Where do other countries stand? And what's their public policy on vaccination? What country should we look to as an example of how to do it right? Sweden? Japan? And what do they do?

Today, according the CIA (the Central Intelligence Agency of the US may be many things, but it's a great source of statistics), the US ranks #49 on lowest infant mortality rates at 6.06 deaths per 1000 live births in 2011. Sweden (2.74) ranks fourth and Japan (2.78) ranks fifth. Monaco (1.79), Singapore (2.32) and Bermuda (2.47) have the top 3 spots. Hmmm.

Population Density
Maybe those countries at the top are lightly populated so people have tons of space there to sneeze without accidentally sneezing on a baby. To the Wiki! Monaco is the most densely population country in the world. It contains 33k people living in two square kilometers. *scratches Monaco off the list of real countries* That is not a country! That's not even a decent city. It's a ding-dang village with a crown. I don't even need to worry about insulting them here cuz there aren't even enough Monaco-type people to have a riot! (And if they did want to have a riot, they have no space to do it in, so nanananana.) Bermuda, also densely populated... 65k people! That's the size of the town I'm living in! And it's not a big town! *mutters* And it's not a proper country, since the Wiki-ers italicized it as a dependency.

Singapore. Yayy it's a real country with 5 million people. Not super-big, but they do have their own Ministry of Health, Health Promotion Board, and traffic jams. At least they're big enough for traffic jams. Population density is the second highest in the world at 7,148 people per square kilometer.

Sweden has all of 21 people per sq km, Japan has 337, the US has 32. Slackers.

All of which is to say it's not population density killing the babies. So maybe it is the vaccines.

Ahh 1960
The US ranking 12th (lowest) in the world for infant mortality in 1960 is cited by the CDC (Table 25 in Health, United States, 2007). In 1960, the US was indeed ranked 12th in the world for low infant mortality, behind Sweden, Netherlands, Norway, Czech Republic, Australia, Finland, Switzerland, Denmark, England & Wales, New Zealand, and Belgium. So the fact that the US continues to lag behind "most European countries" isn't much of a shocker. Those European countries listed had and continue to have comprehensive health care for all residents.

What did those rankings look like in numbers? From Sweden and the US, per 1000 live births: 16.6 and 26.0, respectively. Singapore had 34.8 deaths of infants per 1000 live births in 1960.

The good old days? Hardly.

What Changed
While the US and the world in general have made big strides in lowering infant mortality rates (compare the US at #12 with 26.0 vs the US at #49 with 6.06), a key statistic may be one that Dr. Mercola may have accidentally included, "Today in America, there are more premature babies than ever before." I'm guessing it's not excessive vaccinations of infants affecting the gestation of babies in the US.

It's not a matter of the US not improving the survival rate of infants. It's a matter of many other countries in the world doing a much better job at the same task and passing the US up.

Is it the vaccines? From the Mercola quote, "Doctors give American babies 26 doses of vaccines before age one, which is twice as many vaccinations as babies in Sweden and Japan get." The United States' CDC's schedule of vaccinations is here (put in a birth date and it creates a schedule of 20 vaccinations before age 1). Singapore's Health Promotion Board website lists the vaccination schedule used there: 14 vaccinations before age 1, including the flu vaccine. The US schedule includes vaccination for Hib (2 before age 1) and rotavirus (3 before age 1) not listed on the Singapore schedule, accounting for most of the difference. Yet these are not vaccinations pointed to as the killer culprits by Mercola, who focuses on DPT, given by both countries in 3 doses before the age of 1.

What Are They Doing?
Health Care in Singapore. Also informative, List of Countries with Universal Health Care. Singapore in 1960 ranked 21st lowest for infant mortality. Singapore initiated universal health care in 1993. Singapore ranks 2nd now for lowest infant mortality. The 32 countries with universal health care are coincidentally the same countries with the lowest infant mortality rates and highest life expectancies?

I have so many American friends who say, faced with the brutal facts of the American health care-less system, "Yeah, but universal health care doesn't work." Yeah. Except that it does.