As you know, the maternal mortality rate has been increasing steadily in the US. Except, as Noah Smith informs us, it turns out it hasn't.
This is a bizarre story. In 2003 the standard US death certificate added a pregnancy checkbox. As more and more states adopted the new certificate, reports of maternal mortality went up. But it was all a mirage. In 2020 the CDC performed a detailed study and discovered that when they ignored the checkbox and looked solely at the underlying cause of death, nothing had changed:
Now here's the kicker. If you go to the CDC's main maternal mortality site, it's absolutely littered with stark warnings about this coding problem. In the FAQ it says this:
The [2018] MMR is more than double the rate reported before the checkbox was added, but a rigorous evaluation confirms that the increase in reported rates is almost entirely because of changes in reporting methods. After evaluating more comparable data, the rate has not significantly changed since 1999.
This is unequivocal: the old numbers are wrong and the new numbers are right. But they haven't done anything about it! Figures since 2018 have been released using the old method with only tiny changes. Last year the CDC reported that maternal mortality had exploded in 2021 to a rate of 33 per 100,000 but the report made no mention that this was almost certainly a completely bogus number.
Nobody has done the work to update the figures past 2018, so on an apples-to-apples basis we have no idea what the maternal mortality rate really is. The CDC is just merrily releasing alarming figures that are plainly wrong without providing any clue about how wrong they are. What the actual fuck is going on here?
POSTSCRIPT: Both the old and new methods do agree on one thing: MMR is way higher among Black women than anyone else. And we still don't know why.
I am so angry at the way "americans" treat science.
The CDC is just merrily releasing alarming figures that are plainly wrong without providing any clue about how wrong they are. What the actual fuck is going on here?
Occam's razor: sundry officials are nervous about being accused of "not valuing women's lives" or whatever woke formulation would be employed in the inevitable attack.
The issue seems more that the CDC is defining “Maternal Mortality” as “person dies while pregnant”, rather than “person dies as complications to childbirth”, which is what I suspect most people assume “Maternal Mortality” means.
If that is right, then the CDC is just adopting a more explicit metric, which is probably good. The issue is that it makes comparisons over time tricky, but the CDC is also providing the numbers using the old methodology, if you really wanted to look at that.
I really feel like all of those decisions make sense. Otherwise you could never improve the measurement of anything, which is obviously a bad idea, no?
This is very good to draw attention to, but keep in mind that even under the old metric, the US blows compared to other developed nations. Truly shameful.
The US has a terrible maternal mortality rate compared to other countries, but some states have European MM levels while others are poor by third world standards. Guess which states fall into each category?
Hint: here's the best state — https://www.cmqcc.org/
"MMR is way higher among Black women than anyone else. And we still don't know why."
Uhhh...obesity rates would be the obvious explanation. And all the associated complications that accompany obesity.
You don't think they controlled for anything like that? Because controlling for things like obesity and other health risks is standard practice.
Try again...
https://www.medpagetoday.com/popmedicine/popmedicine/100194
Kevin doesnt explain how he has determined that the reported increase from 2018 to 2021 is "almost certainly a completely bogus number."
He actually admits that he doesnt have any support at all to draw this conclusion, but he makes it anyway.
The CDC tells us that states began changing their data collection method in 2003 and did not fully conclude or implement this change until 2017. This makes 2018 the first year that each state used the new data collection method. The increases from 2003 to 2018 are largely (entirely?) a result of this change in the data collection method.
Given that this data collection change would not appear to impact any comparisons from 2018 forward, its not clear what the point of Kevins complaint is. 2021 cant be compared to the years prior to 2018 due to the data collection change, but comparisons from 2018 to 2021 are accurate.
Yeah, same thoughts here.
If anything, the new data should be more accurate, no? Meaning that the previous numbers were undercounts.
Agreed. Kevin appears to agree that the new data is more accurate, but he's unhappy with something that's hard to decipher.
Then why are more people dying during pregnancy?
That seems... important, even if unrelated to being pregnant.