Maternal and child health report from the Save the Children

Andy’s and my largest charitable contributions go to Save The Children. The day after Mother’s Day, they released their rankings of maternal and child health prospects by country. Download the full report here.

Their maternal health status index is composed of:

a) lifetime risk of maternal death;
b) percent of women using contraception;
c) overall female life expectancy;

Additional measures include:
a) Expected years of formal education;
b) Maternity leave benefits
c) Ratio of estimated female to male wage rates.
d) Participation of women in national politics (percentage of seats).

I might quibble with that last one, as there are many means of political engagement other than the national level, but so far, so reasonable.

For children, the index is somewhat simpler: under-five mortality, elementary school education, and secondary education.

There are several essays worth reading in the report, particularly those on progress in Malawi (horray!!!) and a selection from Rep. Donald Payne and Colonel John Agogliab, both of whom write about how American investment in health and environmental security make all the difference in real security.

However, despite America’s wealth and ability to help other countries, out of 164 countries, the USA ranks 31st.

This is from the FAQ:

One of the key indicators used to calculate well- being for mothers is lifetime risk of maternal mortality. The United States’ rate for maternal mortality is 1 in 2,100 – the highest of any industrialized nation. In fact, only three Tier I developed countries – Albania, the Russian Federation and Moldova – performed worse than the United States on this indicator. A woman in the U.S. is more than 7 times as likely as a woman in Italy or Ireland to die from pregnancy-related causes and her risk of maternal death is 15-fold that of a woman in Greece.

Similarly, the United States does not do as well as most other developed countries with regard to under-5 mortality. The U.S. under-5 mortality rate is 8 per 1,000 births. This is on par with rates in Latvia. Forty countries performed better than the U.S. on this indicator. At this rate, a child in the U.S. is more than twice as likely as a child in Finland, Greece, Iceland, Japan, Luxembourg, Nor- way, Slovenia, Singapore or Sweden to die before reaching age 5.

Only 58 percent of children in the United States are enrolled in preschool – making it the fifth lowest country in the developed world on this indicator.

The United States has the least generous maternity leave policy – both in terms of duration and percent of wages paid – of any wealthy nation.

The United States is also lagging behind with regard to the political status of women. Only 17 percent of congressional seats are held by women, compared to
45 percent in Sweden and 43 percent in Iceland.

Afghanistan, quelle surprise, ranks last. One wonders: is it morally worse to be a poor and battle-torn country where woman are treated miserably, or a tremendously wealthy country that could radically alter its own ranking–but doesn’t–but where women are much better off than in many other places?

David King on Richard Florida’s leaps from logic

Richard Florida, having always been a little light on the “how to use data” side, has really drunk the New Urbanist Kool-Aid here late, and it’s been hard to sit through. One of his latest “light on evidence, heavy on major claims” forays explains to us in the Atlantic how commuting is, basically as bad for us as smoking or obesity. Here’s a quote:

Commuting is a health and psychological hazard, not to mention the carnage and wasted time on our over-clogged roads. It’s time to put commuting right beside smoking and obesity on the list of priorities for improving the health and well-being of Americans.

Are you kidding me? My walk to USC takes me an hour. The car trip takes me 15 minutes. I’m pretty sure that the hour is the healthiest part of my day, and that commute time has little to do with health. I get that when Florida says “commuting” he’s thinking car, but he’s addled up the theorized relationship between commuting time and health in so many ways my eyes are crossed.

I don’t have the energy to go into everything that is wrong with his claims, but fortunately David King from Columbia did take some time out to break down the problems. Take a look.

Here’s a couple of favorite quotes from King:

A more inconvenient truth for Florida is that the extreme commuters–those with commutes over 90 minutes–are most likely to get to work by commuter train. Advocates for rail transit to reduce commuting costs should be careful what they wish for. People driving to work alone have the shortest commutes, and commutes are growing most in suburb-to-suburb travel which are poorly served by any transit but rail in particular. The megaregions that Florida and others hold so dearly are also polycentric regions with employment centers spread out all over the place.

link: Getting from here to there: Commuting is not bad for you

Commutes by transit are, on average, longer than in duration than car commutes, by any data set you use. So…I guess since according to the commutes are bad logic, transit commutes are so long that transit is actually bad for health. Sweet cracker sandwich. Maybe transit commuters spend so much time waiting for transfers they can’t go to the gym?

One point to note: King suggests that about half of US commuters commute less than 20 minutes. One thing he leaves out: that figure has remained remarkably stable over the years that we have been collecting data on commutes. My speculation is that if we could get transit commutes down to 20 minutes they would be much more competitive with cars (but they would also be competing with bicycles, too); I suspect that many people just have travel budgets, and over time people adjust their residential locations according to their preferred access locations–not necessarily the work location. I also suspect that many of the very long commutes we see in the data are people who don’t commute every day but still report their commute length, or are people in a “change mode”–they are in the process of changing jobs or lifestyles, and they are putting with a longer commute for constrained time period until the “right time to move” comes up. Leases are sticky, and so is house buying and selling. Cross-sectional data doesn’t describe these very well.

Another point, from commuting in America II:

Contrary to what some might expect, it is the smaller metropolitan areas that show strong center city dominance. In areas below 100,000 population, The internal center city flows alone are about half of all flows, but drop to below 24% at the highest metro size levels

King highlights this but doesn’t go the full way of critiquing the assumption: why anybody wouldn’t expect polycentricity to grow with region size is beyond me. It’s what urban economics would teach us to expect as a land market response to higher downtown costs.

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