Chicken little forecast

Still Chugging Along

Volcanoes are erupting in The Philippines, but on-fire Australia received some welcome rain. The Iran war cries have been called off and The Donald’s military powers are about to be hamstrung by the Senate. Meanwhile, his impeachment trial is starting, and we’re all on Twitter for a front-row seat.


What Could Go Right? When the culprit is data

Is the alarm over maternal mortality rates in the US warranted?

Emma Varvaloucas

Emma Varvaloucas

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When the culprit is data

“Maternal mortality soars in America.” “US maternal mortality rates have almost doubled in the last two decades.” “Alarming rise in US maternal mortality signals need for change.” 

This sampling of recent headlines fits nicely with the popular impression that the United States is a failing country with health outcomes that lag behind its peers. 

But is the data underlying these headlines accurate? 

In November I wrote about the worldwide decline of child mortality rates and as part of that research looked at the Centers for Disease Control and Prevention’s (CDC) data on pregnancy-related mortality in the US. On that page, the CDC writes that pregnancy-related deaths have risen since 1987, when a surveillance system for them was put into place. They also add that there are questions around how the data is collected, “potentially leading to overestimation of the number of pregnancy-related deaths.”

That raised an eyebrow. I’m no public health expert, but it seemed odd that a nation with a 22 percent decline in infant mortality between 2002 and 2021 had simultaneously worsened outcomes for mothers so badly. Add in the CDC’s data caveat, and I was officially on the lookout for an explanation.

I was delivered one this week via the economist Noah Smith’s Substack, where he highlighted a 2021 study of an investigation by The National Center for Health Statistics (NCHS), a unit of the CDC, that seems to have slipped under the media’s radar. The authors write:

“ . . . detailed reports by the [NCHS] . . . showed that there had been no temporal increase in overall maternal death rates in the United States. The rising trend in maternal mortality rates was entirely an artifact of changes in maternal death surveillance.” 

How come everyone says otherwise, then? 

A pregnancy checkbox was introduced onto death certificates in 2003 and picked up by states at different times. The checkbox caught some previously missed cases. But it also led to a progressive increase in recorded maternal deaths for causes labeled as a generic “other,” whereas specific causes like anesthesia complications, preeclampsia, blood clots, and so on showed significant declines.

Chart: Maternal deaths per 100,000 live births

NCHS re-crunched the numbers without including the pregnancy checkbox and found that between 2000 and 2018, age-adjusted maternal mortality rates declined by 21 percent

That puts the US rate at 8.7 per 100,000 live births in 2018, so in the company of Canada and France, but lagging behind Germany, Japan, the Netherlands, and others. From an absolute numbers standpoint, this is under 1,000 deaths every year.

Table: Maternal mortality ratio

The authors take care to say that there is plenty that the US can improve upon. Racial disparities did not magically disappear, for instance, with maternal mortality rates 2.5 times higher among black women than white (and lowest among Hispanic women). And I would guess that rates, pregnancy checkbox or no, increased during the pandemic years.

But it does complicate the overall picture of a nation failing its expectant mothers. Changing the way that data is collected is a different story than deteriorating obstetric care.

Homelessness: a (bad) update

Last month I wrote that homelessness had not spiked in the US, comparing numbers from 2007, when reporting began (647,258 total homeless) with 2022 (582,462). It was the end of the year, and I should have known not to write about data that was about to be updated.

The 2023 data is now out, and homelessness has definitely spiked. We have regressed, surpassing 2007’s count with 653,100 total homeless in 2023.

Axios has the breakdown here. My apologies for the poorly timed piece, and now for the bad update.

Quick hits

  • Cape Verde became the third African country to be declared free of malaria, which means that there haven’t been any local cases of transmission for three years. It’s the first sub-Saharan country to be given the status in 50 years. 
  • The Food and Drug Administration (FDA) has recommended reclassifying marijuana as a Schedule III substance. It has been classified as Schedule I since the 1970s, along with heroin, LSD, and ecstasy—drugs with a high abuse risk and no medical use. A new classification could have several downstream effects for state tax and criminal codes. The Drug Enforcement Association (DEA) will have the final say.

Below in the links section, volcano power, portable X-ray machines, AI-boosted research, and more.

People in the UK walk past screens showing positive news
Our friends at Positive News will be sharing stories of progress on thousands of screens in public spaces across the UK. The displays, Positive News says, “will highlight a range of recent constructive UK stories that people might have not seen in traditional news outlets or on social media, joining the dots between how people, communities and organisations are changing the world for the better.”

What Could Go Right? S5 E14

Promotional image for S5 E14 of the What Could Go Right? podcast

What’s really happening on college campuses? Is free expression on them dead, or have we reached peak cancel culture? And why have younger generations completely abandoned the principles behind free speech? Today, we’re joined by attorney Greg Lukianoff, the President and CEO of the Foundation for Individual Rights and Expression (FIRE), who shares his perspective and his hopes for the role of free speech defenders and alternative approaches to higher education. | Listen to the episode

Progress, Please

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Other good stuff in the news 🌋

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TPN Member originals 🧠

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Department of Ideas 💡
(A staff recommendation guaranteed to give your brain some food for thought.)

Why our fear of cancer is outdated—and harmful | The Washington Post

Why we picked it: “The public is mostly unaware of the quiet, incremental progress that has made so many cancers treatable or curable,” David Ropeik writes. “Very few know that many common cancers never kill.” Can we update our fear of it to be more aligned with the facts? —Emma Varvaloucas

Until Next Time

Evergreen thoughts on the art of perspective. 🕰️ 🔍

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Emma Varvaloucas

Emma Varvaloucas is the Executive Director of The Progress Network. An editor and writer specializing in nonprofit media, she was formerly Executive Editor of Tricycle: The Buddhist Review and is the editor of two books from Wisdom Publications.