History > 2008 > USA > Demographics (I)

Infant Deaths Decline in U.S.

October 16, 2008
The New York Times
By GARDINER HARRIS

WASHINGTON — Infant deaths in the United States declined 2 percent in 2006, government researchers reported Wednesday, but the rate still remains well above that of most industrialized countries and is one of many indicators suggesting that Americans pay more but get less from their health care system.

Infant mortality has long been considered one of the most important indicators of the health of a nation and the quality of its medical system. In 1960, the United States ranked 12th lowest in the world, but by 2004, the latest year for which comparisons were issued by the Centers for Disease Control and Prevention, that ranking had dropped to 29th lowest.

This international gap has widened even though the United States devotes a far greater share of its national wealth to health care than other countries. In 2006, Americans spent $6,714 per capita on health — more than twice the average of other industrialized countries.

Some blame cultural issues like obesity and drug use. Others say that the nation’s decentralized health care system is failing, and some researchers point to troubling trends in preterm births and Caesarean deliveries.

Many agree, however, that the data are a major national concern. More than 28,000 infants under the age of 1 die each year in the United States.

“Infant mortality and our comparison with the rest of the world continue to be an embarrassment to the United States,” said Grace-Marie Turner, president of the Galen Institute, a conservative research organization. “How can we get better outcomes?”

The data, collected by the Centers for Disease Control and Prevention, indicate that the nation’s infant mortality rate has been static for years despite enormous advances in the care given to preterm infants. Two-thirds of the infant deaths are in preterm babies.

In 2006, 6.71 infants died in the United States for every 1,000 live births, a rate little different from the 6.89 rate reported in 2000 or the 6.86 rate of 2005. Twenty-two countries had infant mortality rates in 2004 below 5.0 infant deaths per 1,000 live births, with many Scandinavian and East Asian countries posting rates below 3.5. While there are some differences in the way countries collect these data, those differences cannot explain the relatively low international ranking of the United States, according to C.D.C. researchers.

Preterm birth is a significant risk factor for infant death. From 2000 to 2005, the percentage of preterm births in the United States jumped 9 percent, to 12.7 percent of all births. The most rapid increase has been among late preterm births, or babies born at 34 to 36 weeks of gestation. Some 92 percent of these increased premature births are by Caesarean section, according to a recent study.

Dr. Alan Fleischman, medical director of the March of Dimes Foundation, said that a growing number of these late preterm births might be induced for reasons of convenience. “Women have always been concerned about the last few weeks of pregnancy as being onerous,” he said, “but what we hadn’t realized before is that the risks to the babies of early induction are quite substantial.”

Dr. Mary D’Alton, chairwoman of the department of obstetrics and gynecology at Columbia University, said that doctors should not induce labor before 39 weeks of gestation unless there is an urgent medical or obstetrical need. For unknown reasons, the number of preterm births is far higher among African-American women even when those women have access to good medical care, Dr. D’Alton said.

There is some evidence, Dr. D’Alton said, that steroids given to mothers at risk of giving birth early may help. A trial to test this theory is about to start.

Some economists argue that the disappointing infant mortality figure is one of many health indicators demonstrating that the health care system in the United States, despite its enormous cost, is failing.

Although the United States has relatively good numbers for cancer screening and survival, the nation compares poorly with other countries in many other statistical categories, including life expectancy and preventable deaths from diseases like diabetes, circulatory problems and respiratory issues like asthma.

Ms. Turner blamed socioeconomic factors like obesity, high drug use, violence with guns and car accidents — factors that she said cannot be addressed by health reform. Karen Davis, president of the Commonwealth Fund, a nonprofit research organization, agreed that socioeconomic factors played a role but said that the nation’s heavy reliance on the private delivery of care was also to blame.

“We’re spending twice what other countries do,” Ms. Davis said, “and we’re falling further and further behind them in important measures like infant mortality.”

    Infant Deaths Decline in U.S., NYT, 16.10.2008, http://www.nytimes.com/2008/10/16/health/16infant.html

The End of White Flight

For the First Time in Decades,

Cities' Black Populations Lose Ground,

Stirring Clashes Over Class, Culture and Even Ice Cream

July 19, 2008
The Wall Street Journal
Page A1
By CONOR DOUGHERTY

Decades of white flight transformed America's cities. That era is drawing to a close.

In Washington, a historically black church is trying to attract white members to survive. Atlanta's next mayoral race is expected to feature the first competitive white candidate since the 1980s. San Francisco has lost so many African-Americans that Mayor Gavin Newsom created an "African-American Out-Migration Task Force and Advisory Committee" to help retain black residents.

"The city is experiencing growth, yet we're losing African-American families disproportionately," Mr. Newsom says. When that happens, "we lose part of our soul."

For much of the 20th century, the proportion of whites shrank in most U.S. cities. In recent years the decline has slowed considerably -- and in some significant cases has reversed. Between 2000 and 2006, eight of the 50 largest cities, including Boston, Seattle and San Francisco, saw the proportion of whites increase, according to Census figures. The previous decade, only three cities saw increases.

The changing racial mix is stirring up quarrels over class and culture. Beloved institutions in traditionally black communities -- minority-owned restaurants, book stores -- are losing the customers who supported them for decades. As neighborhoods grow more multicultural, conflicts over home prices, taxes and education are opening a new chapter in American race relations.

Part of the demographic shift is simple math: So many whites had abandoned cities over the past half-century, there weren't as many left to lose. Whites make up 66% of the general U.S. population, but only about 40% of large cities. Sooner or later, the pendulum was bound to swing back, and that appears to be starting.

The Census data "suggests that white flight from large cities may have bottomed out in the 1990s," says William Frey, a demographer at the Brookings Institution, a Washington think tank.

For instance, while most of the 50 largest cities continue to see declines in the share of whites, it is at much-reduced rates. In Los Angeles the share of the white population declined only about a half a percentage point between 2000 and 2006, compared to a 7.5-point decline the previous decade. Cities including New York, Fort Worth and Chicago show a similar pattern.

'Natural Decrease'

Demographic readjustments can take decades to play out. But if current trends continue, Washington and Atlanta (both with black majorities) will in the next decade see African-Americans fall below 50% for the first time in about a half-century.

Meantime, in San Francisco, African-American deaths now outnumber births. Once a "natural decrease" such as this begins, it's tough for the population to bounce back, since there are fewer residents left to produce the next generation. "The cycle tends to be self-perpetuating," says Kenneth M. Johnson, senior demographer at the Carsey Institute at the University of New Hampshire.

There are myriad factors driving the change. In recent years, minority middle-class families, particularly African-Americans, have been moving to the suburbs in greater numbers. At the same time, Hispanic immigrants (who poured into cities from the 1970s through the 1990s) are now increasingly bypassing cities for suburbs and rural areas, seeking jobs on farms and in meat-packing plants.

Cities have spent a decade tidying up parks and converting decaying factories into retail and living space. That has attracted young professionals and empty-nesters, many of them white.

The shift has put the future at odds with the past. New York City's borough of Brooklyn has seen its proportion of whites grow to 36.1% in 2006 from 35.9% in 2000 -- the first increase in white share in about a century.
 

Hoarding Computers

While the root of neighborhood conflicts is often money or class differences between white-collar and blue-collar workers, it often unfolds along racial lines. About two years ago Public School 84, in a largely Hispanic section of Brooklyn, meetings of the Parent Teacher Association started drawing a more professional, wealthier and whiter group of parents.

Soon, disagreements spilled into the open. Arguments concerned everything from how PTA money was spent, to accusations that some white parents were hoarding computers for their kids.

Even ice cream became a point of contention: In the past year, a group of mostly white parents took issue with a school tradition of selling ice cream to raise money. They felt the school shouldn't be serving sugary foods to kids, but the break with tradition angered many minority parents who felt the sales were an important source of money and that ice cream is a harmless treat.

"It was a gigantic fight," says Brooke Parker, who is white and whose daughter attended the school last year. "If the school is saying 'It's OK to give out ice cream' while at the same time they're holding workshops on how to deal with your kid's Type 2 diabetes, maybe we should rethink the message we're sending."

Relations got testy enough that about 20 kids, most of whom were white, transferred to private schools or other public schools. "I don't think the battleground against gentrification should take place in the schools," says Ms. Parker, who withdrew her own daughter from P.S. 84 as tensions built. "It seemed nothing could get accomplished," she said.
 

Cries of 'Segregation'

A few months later, a small group of families, most of them white, proposed establishing a new public school, to be located inside the existing P.S. 84. Hundreds of minority parents reacted by putting out a press release calling it de facto segregation. The proposal is "clearly discriminatory," the release said. "Children will suffer the effects of negative stigma as a result of this segregation which will send our City back 120 years!"

"I honestly felt like they didn't want to mix our children with their children," says Virginia Reyes, vice president of the PTA at P.S. 84 who has two foster children at the school. "It upset me a lot."

A spokeswoman for the New York City Department of Education says, "We obviously would not and could not open segregated schools." The department says the new school didn't get the go-ahead because it didn't have broad enough community support.

Backers of the new school couldn't be reached.

Elsewhere in Brooklyn, in a majority African-American section of the borough, Councilwoman Letitia James says a handful of predominantly white parents last year asked her if some of their local tax money could be steered to schools in a nearby neighborhood. The parents wanted their kids in schools with a more diverse racial mix, Ms. James says, rather than the majority-black schools in her district.

The parents felt "tax dollars should follow the children, and not the school," Ms. James says. She denied their request.

There's a century's worth of history behind the ebb and flow of whites and minorities in urban America. Rural blacks began flocking to cities more than a century ago, lured by factory jobs. After World War II, whites headed for the suburbs as the great postwar building boom got rolling, while African-American families stayed in the cities, partly because they were often denied access to home loans that whites could get. In the 1970s Hispanic immigrants surged into cities, chasing service jobs and further diluting the share of whites. By the 1980s, as cities hemorrhaged manufacturing jobs, blacks and whites both left -- but whites at a higher rate.

Cities Get a Makeover

Today, cities are refashioning themselves as trendy centers devoid of suburban ills like strip malls and long commutes. In Atlanta, which has among the longest commute times of any U.S. city, the white population rose by 26,000 between 2000 and 2006, while the black population decreased by 8,900. Overall the white proportion has increased to 35% in 2006 from 31% in 2000.

In other cities, whites are still leaving, but more blacks are moving out. Boston lost about 6,000 black residents between 2000 and 2006, but only about 3,000 whites. In 2006, whites accounted for 50.2% of the city's population, up from 49.5% in 2000. That's the first increase in roughly a century.

Tracking population shifts is an inexact science. Changes in how Census data are tallied makes for imprecise comparisons across decades. Hispanics, for instance, were mostly lumped in with whites until 1980, potentially overstating the white population in earlier decades. Also, losses of African-Americans from cities are often disproportionate to other minorities because unlike, say, Hispanics or Asians, the inflow of black immigrants into the U.S. isn't big enough to offset the loss of African-Americans to the suburbs.

Washington -- where African-Americans have been in the majority for a half-century -- has lost about 80,000 black residents between 1990 and 2006. Whites had been leaving, too, but recently they've started coming back. Between 2000 and 2006, Washington gained 24,000 whites and lost 21,000 blacks. Whites are now 32% of the population, up from 28% in 2000.

Churches Take a Hit

This is a problem for Washington's African-American churches. The past few years, numerous black churches have relocated to suburban Prince George's County, Md., to follow their parishioners. Later this year, Metropolitan Baptist Church (founded by freed slaves during the Lincoln administration) plans to leave town as well.

Some of the remaining black churches are now courting white members. On a recent Sunday, the Rev. John Blanchard, the 64-year-old pastor at Ebenezer United Methodist Church, preached to a thin crowd; several pews were empty. About half his parishioners now live in the suburbs and drive into the city for services. High gasoline prices aren't helping attendance.

So Mr. Blanchard says he's planning to add a white intern to preach with him, in hopes of filling more pews. "You've got to love the one you're with," he says, "but you also need to adjust to the environment you're in."

While his church flounders, the predominantly white Capitol Hill United Methodist Church just down the street is flourishing. There the average attendance on Sundays has doubled to about 120 people the past five years. "Demographics are in our favor. We're attracting the folks that are moving in," says the Rev. Ginger Gaines-Cirelli, 38, who headed the church for five years before recently leaving for a position elsewhere.

In San Francisco, the African-American population has fallen by a third, or about 30,000 people, since 1990, largely due to surging housing costs and redevelopment that destroyed some public housing. Mayor Newsom's African-American Out-Migration Task Force, set up last year, has a two-pronged strategy: keep African-Americans from leaving, and promote affordable housing and cultural institutions like a jazz center to try to lure blacks back. "The greatness of our city and region is in its diversity," Mayor Newsom says.

So far, his efforts have focused on residents of public housing, about half of whom are black. The city is trying to prevent evictions by building new community centers where residents can get job training and help with the rent. The city is also giving residents displaced by redevelopment, many of whom are black, an inside track on affordable-housing units.

From Poor to Poorer

As middle-class African-Americans have left San Francisco, the remaining black population has gone from poor to poorer. In 1990, half of the city's African-American population was very low-income; by 2005, that number swelled to about two-thirds. The number of black-owned businesses fell 25% between 1997 and 2002.

As blacks migrated to San Francisco's suburbs, so too have many social activities centered on the community. The San Francisco Chapter of the National Black MBA Association has started hosting many of its events across the bay in Oakland.

The Western Addition, a historically black neighborhood in San Francisco once home to many jazz clubs, has lost much of that character. Powell's Place, an iconic soul-food restaurant that had been located in or around the neighborhood since the 1970s, has moved to Bayview-Hunters Point. Charles Spencer, who owns a barbershop catering to black men, says he has lost many of his customers and is trying to diversify. His Web site has a picture of a white client to go with three black faces.

'An Act of Faith'

The city has celebrated its traditional black culture by designating a stretch of Fillmore Street the "Fillmore Jazz Preservation District," yet the businesses that defined the era are now gone or dying. Raye Richardson, owner of Marcus Book Stores -- its motto is "Books by and about black people everywhere" -- has been in the Fillmore district since 1946. She remembers the clubs, the black tailor shops and the many black residents who supported her shop. Today, Ms. Richardson says her store is losing money; much of her business comes from mail-order traffic.

"San Francisco has so few blacks now, that it's just an act of faith to stay open," says Ms. Richardson, 88.

Sherri Young, executive director at the African-American Shakespeare Company in San Francisco, is one of the few blacks at her theater company who still lives in San Francisco. "I'm a single woman in my late 30s," Ms. Young says. "Culturally, it's difficult."

Recently, she says, her production of "The Comedy of Errors" drew a mostly white audience. It's the first time that's happened since she founded the company 14 years ago.

    The End of White Flight, WSJ, 19.7.2008, http://online.wsj.com/article/SB121642866373567057.html?mod=home_we_banner_left

Is this the next baby boom?

16 July 2008
USA Today
By Sharon Jayson

A record number of babies were born in the USA in 2007, according to early federal data released Wednesday that some demographers say could signal an impending baby "boomlet."

The 4,315,000 births in 2007, reported as "provisional" data by the National Center for Health Statistics, gives just a glimpse of what's ahead in the nursery.

"I can't tell you anything about who's having these babies, but it is an early look and there is an increase," says federal demographer Stephanie Ventura. "It's a milestone."

She says details about the mothers won't be available until the fall, because all the agency has now is birth certificate data from state health departments.

The last time the number was this high was in 1957, in the middle of the baby boom years; about 78 million Americans were born from 1946 to 1964. Demographers have been monitoring gradual increases in recent years; data for 2006, which won't be made final until September, show a 3% increase over 2005. That's the largest single-year increase since 1989.

"I suspect this is the beginning of a new kind of baby boom, although it's going to be nowhere near the baby boom of the 1950s or '60s," says demographer Arthur Nelson of the University of Utah in Salt Lake City. "It will be sort of a boomlet."

To be considered a real boom, demographers say, the percentage increases would have to be much larger than the single-digit increases we're seeing now.

The last time there was talk of a boomlet was during the 1980s and '90s. Those babies were sometimes known as "Echo Boomers" and today are called Millennials or Generation Y.

Nelson attributes the 2007 numbers to a "perfect storm" of factors: more immigrants having children, professional women who delayed childbearing until their 40s, and larger numbers of women in their 20s and 30s in the population, keeping the fertility rate high. The average number of births per woman was 2.1 in 2006, the highest since 1971.

"We have three different phenomena around birth happening at the same time," he says.

But family demographer Ronald Rindfuss of the University of North Carolina-Chapel Hill says there is a bigger question looming than who's having kids.

"From the perspective of schools that have to educate these children, this is a real increase in the number of births and something they're going to have to deal with," he says. But it won't be "the kind of shock that we saw at the beginning of the baby boom. In 1952 and '53, in many parts of the country, schools had to run double sessions. This is a gradual increase."

LIVE U.S. BIRTHS BY YEAR

Year Live births

1909          (Greatest Generation born before 1928)  2,718,000

1910            2,777,000

1911            2,809,000

1912            2,840,000

1913            2,869,000

1914            2,966,000

1915            2,965,000

1916            2,964,000

1917            2,944,000

1918            2,948,000

1919            2,740,000

1920            2,950,000

1921            3,055,000

1922            2,882,000

1923            2,910,000

1924            2,979,000

1925            2,909,000

1926            2,839,000

1927            2,802,000

1928 (end Greatest Generation) 2,674,000

1929 (begin Lucky Few) 2,582,000

1930            2,618,000

1931 2,506,000

1932 2,440,000

1933 2,307,000

1934 2,396,000

1935 2,377,000

1936 2,355,000

1937 2,413,000

1938 2,496,000

1939 2,466,000

1940 2,559,000

1941 2,703,000

1942 2,989,000

1943 3,104,000

1944 2,939,000

1945 (end Lucky Few) 2,858,000

1946 (begin Baby Boomers) 3,411,000

1947 3,817,000

1948 3,637,000

1949 3,649,000

1950 3,632,000

1951 3,820,000

1952 3,909,000

1953 3,959,000

1954 4,071,000

1955 4,097,000

1956 4,210,000

1957 4,300,000

1958 4,246,000

1959 4,286,000

1960 4,257,850

1961 4,268,326

1962 4,167,362

1963 4,098,020

1964 (end Baby Boomers) 4,027,490

1965 (begin Generation X) 3,760,358

1966 3,606,274

1967 3,520,959

1968 3,501,564

1969 3,600,206

1970 3,731,386

1971 3,555,970

1972 3,258,411

1973 3,136,965

1974 3,159,958

1975 3,144,198

1976 3,167,788

1977 3,326,632

1978 (Generation X/Millennials overlap) 3,333,279

1979 (Generation X/Millennials) 3,494,398

1980 (Generation X/Millennials) 3,612,258

1981 (Generation X/Millennials) 3,629,238

1982 (Generation X/Millennials) 3,680,537

1983 (Millennials) 3,638,933

1984 3,669,141

1985 3,760,561

1986 3,756,547

1987 3,809,394

1988 3,909,510

1989 4,040,958

1990 (Millennials peak) 4,158,212

1991 4,110,907

1992 4,065,014

1993 4,000,240

1994 3,952,767

1995 3,899,589

1996 3,891,494

1997 3,880,894

1998 3,941,553

1999 3,959,417

2000 (end Millennials?) 4,058,814

2001 4,025,933

2002 4,021,726

2003 4,089,950

2004 4,112,052

2005 4,138,349

2006 4,265,996

2007 4,315,000

Source: National Center for Health Statistics;

2006 and 2007 data not final;

1959 and earlier data adjusted for under-registration.

Is this the next baby boom?, UT, 16.7.2008, http://www.usatoday.com/news/nation/2008-07-16-baby-boomlet_N.htm