Today's thoughts on public stats:

What's the connection between life expectancy, infant mortality, and prenatal care?

It could be that better prenatal care leads to higher infant mortality and lower overall life expectancy

There are people being born in the United States with severely compromised health -- and being counted as live births. Babies are being born at 24 weeks gestation and surviving, and many don't survive because it's really tough to keep babies that small and underdeveloped alive. Remember, "full-term" babies are at 38-42 weeks or so. These are babies about 3-4 months premature.

Let's face it -- in other countries, many of these children would die soon after birth if not before birth.

In some countries, babies have to be alive for a minimum amount of time to be considered a live birth. We've got stats on 48-hour mortality here in the U.S., which should tell you something. (I think the March of Dimes has links to these stats. Maybe they get them from NIH?)

So, the better the prenatal care, the more likely high-risk pregnancies will end in a live birth, albeit in compromised circumstances which are likely to have worse health outcomes. A country could have horrendous prenatal care, and only the hardiest of fetuses make it all the way through the process. No babies with heart defects, no babies born underweight - they'll simply die before birth.

The only way to really break down infant mortality stats is to see why the babies died, and what situation were they in when they were born. Did they die because they had poor health care after birth? Or did they die because high-tech medical care allowed them to reach birth alive, and could do only so much after they were born? Or did the child die because of horrible abuse from a caretaker? (in which case the health care system can't be blamed... sometimes particular govt agencies can, but it's not because the hospitals lacked adequate care.) Or something else? Who knows?

This can also result in lower overall life expectancy, not just because of higher infant mortality stats, but because people who wouldn't have been born alive might have compromised health for their entire lives, and likely die earlier.

How much any of these effect public health stats depends on their frequency. Already, there have been noted effects of multiple births as a result of fertility treatments and older mothers (who naturally are more liable to multiple births, even without artificial help). Multiple births are connected to lower birth weights, and other troubles. This undoubtably has effects on infant mortality rates.