Learning to Read Carefully
I ran into an infographic titled A Breakdown of Birth in the U.S.A. I wanted to like it, but the information on the poster is misleading. It does make a great little demonstration of how to learn to question what you read.
If you haven’t opened the infographic yet, put it in a new window and lets talk about the problems.
Always ask yourself first where the data is coming from. Notice the infographic provides only three sources for the data (which are nearly impossible to read), but I find that highly suspect given the variety of information the infographic shares. This is troublesome because grabbing data to verify the numbers will be difficult. When I follow the links I find my suspicions correct, the data is from many sources.. So we are left without knowing what year the census data is from and wondering why only the birth defects data was taken from the CDC. This author didn’t actually check the third source to see if the data were presented properly from the articles used.
Costs of birth
The problem here is this presentation is a bit vague — and you are going to see vague presentations of data pretty often. Is this author trying to say the United States spends the most per birth, or the most overall? Or, we might wonder if the costs are out-of pocket expenses or sticker price or insurance reimbursement. Without being able to verify the source I would still guess this is true, but misleading. The United States has one of the highest spending on health care per person for just about EVERY health condition, why would childbirth be different?
The United States has the third largest population in the world, so we will be expected to have the third largest number of births per year, and at least the third largest overall cost of delivery care because of that. The countries with higher population are China and India. Only about half of the births in India are attended by a skilled birth attendant which makes considerable changes in the cost. China has a high rate of hospital delivery, but the health system is considerably different. For comparison, the World Bank says the US spends $8,895 on health care per capita while China spends $322. Big difference. So while this statement is probably not inaccurate, it isn’t helpful for understanding anything about birth in the United States.
It is interesting to me that the data is given for the costs of birth in a hospital because as a researcher I will tell you this is a very difficult number to get. Actually, any hospital cost data is very difficult to get. We know what Medicaid reimburses hospitals, but other insurance programs guard their cost data as proprietary. Cost data presented in research are estimates at best, and vary considerably based on the type and source of data. Also remember, the cost of the physician or midwife is often separate from the cost of the hospital making good data even harder to compile. Regardless, the data I have seen does not suggest a doubling in reimbursement or out of pocket costs for a cesarean birth, and I have never been able to find a valid source to confirm a doubled “sticker price” as the norm.
Infant Mortality really deserves a post of its own. While many birth advocates hold this statistic up as evidence we need to change our style of managing birth, data shows it is more related to the ignored problems of poverty and racism. Check out the data in this report to start getting an idea of what I am talking about.
The infographic then moves into a short social commentary, data about who should and should not be a mother. Except the data again is misleading. There is a huge difference between a 12 year old being pregnant and an 18 year old pregnant, but this statistic wraps them in together. You will see this happen pretty often as well, authors will use data groupings that provide shock value. When you look at the breakdown (See Table 2), you will see the number of births doubles with each increase in age so the total number of births to women less than 18 is about 87K, and more than half of those are to women 17 years old. The idea that an 18 or 19 year old woman should not be coupled and bearing children is a societal standard that doesn’t fit all cultures within the United States. And don’t make the mistake of reading unmarried as uncoupled.
But then the infographic moves into birth defects – and gives a statistic that is global rather than specific to the United States. The author changed scale without telling you. Be on the lookout for this type of problem in writing because it happens more often than you think. It makes the graphic confusing (how can there be 8 million babies with birth defects if there are only 4 million births?). A better statistic could have been found.
I’m not really sure what the rest of the information is supposed to tell us about birth, but it is added perhaps because the infographic creator wanted to fill more space.
Be a Better Reader
Those are my quick comments about this infographic. I hope that helps you see some of the issues involved in sharing data and helps you become a more critical reader of the statistics when they are presented.
Next time we will look deeper at how to understand the statistic by looking at the measure.