January 15, 2018

By W. T. Whitney Jr.

“The U.S. is the most dangerous of wealthy, democratic countries in the world for children … Across all ages and in both sexes, children have been dying more often in the U.S. than in similar countries since the 1980s.”  These were an author’s observations to an interviewer on a study of death rates of death rates of U.S. children he and other authors had published online January 8 in Health Affairs.

The upshot is that children in a society emblematic for capitalization industrialization are in trouble. But that’s to be expected because capital by its nature is dangerous for women and children.

In their summary, the study’s authors say that, “we examined mortality trends for [20] nations in the Organization for Economic Cooperation and Development (OECD) for children ages 0–19 from 1961 to 2010 using publicly available data.” They discovered that, “Over the fifty-year study period, the lagging US performance amounted to over 600,000 excess deaths.” Some 90 percent of these deaths occurred among infants and adolescents 15 to 19 years old.

They report that, “While child mortality progressively declined across all countries, mortality in the US has been higher than in peer nations since the 1980s.” Specifically, “From 2001 to 2010 the risk of death in the US was 76 percent greater for infants and 57 percent greater for children ages 1–19. During this decade, children ages 15–19 were eighty-two times more likely to die from gun homicide in the US.”

Information is available elsewhere corroborating these findings. In 2013, the United Nations Children’s Fund ranked the U.S. 25th in a list of 29 developed countries for overall child health and safety. African-descended infants in the United States are most at risk for preventable deaths.  The overall U.S. infant mortality rate (IMR) for all babies in 2015 was 5.9. (The IMR is the number of babies dying during their first year of life for every group of 1000 babies born alive.) The IMR for white babies was 4.8; that for black and Hispanic babies was 11.4 and 5.2, respectively.

The Health Affairs article centers on the fate of U.S. children, but the fact that U.S. mothers experience similarly dreadful health outcomes suggests the possibility of causative factors that are shared.  A measuring stick for women’s health is the maternal mortality rate (MMR), which is the number of women per 100,000 births who die from childbirth –related causes during pregnancy, childbirth, and 42 days thereafter.

In the United States the MMR for 1990, 2000, and 2015 was 16.9, 17.5, and 26.4, respectively. The comparable Canadian figures were 6.0, 7.7, and 7.3, respectively. Over those 25 years, the MMR decreased globally by an average of 1.5 percent per nation per year. Over the same period, the U.S. MMR increased at an average rate of 1.8 percent per year.   U.S. worldwide rankings for maternal mortality are unfavorable; its MMR for 2010 showed up in 48th place and overall U.S. performance in delivering maternal health carewas stuck in 61st place in 2015.  In 2012 the MMR for black mothers in the United States was almost four times that for white women.

Data reflecting dismal health outcomes beg for explanation. A recent article appearing in Monthly Review suggests that capitalism in its full flowering creates circumstances that, arising from an alternative mode of capitalist accumulation, are unfavorable to the health of mothers and children.

That way of accumulating has nothing to do with the well-known capacity of capital for extracting surplus value from the production of commodities. In that instance, the monetary value of commodities enables capitalists to regulate surplus value and thus gain the ability to exploit workers. But how do they bend to their purpose of accumulation other sectors of the population less susceptible to exploitation, notably women? 

Capitalists have an interest in their workforce being renewed. They’ve relied on a process that Marx, Engels, and their followers have labeled “social reproduction.”  The fodder for social reproduction, of course, is children. Its agents are women.  Social reproduction takes place in homes where large-scale production of commercially valuable commodities is not possible. Nevertheless, homes can be venues for accumulation, if by extraordinary means. 

Citing the investigations of others, the Monthly Review authors say that, “those areas outside commodity production, including both the reproduction of labor power and what could be expropriated from nature, were considered ‘free gift[s] … to capital’” (Marx’s words). Indeed, capital demonstrates a “necessary and continuing attempt to transcend or readjust its boundaries with respect to its external conditions of production.” Thus “capital constantly seeks to expropriate what it can from its natural and social environment.”

They cite Marilyn Waring who suggested that, “the treatment of Mother Earth and the treatment of women and children in the system of national accounts have many fundamental parallels.” They conclude that capitalists in both situations have resorted to “actual robbery – usurpation, expropriation, dependence, enslavement.”

Presently in the United States a laboratory experiment of sorts is underway which shows off children and women as victims of stealing. The U.S. Congress is on the verge of ending the government’s Children’s Health Insurance Program (CHIP), which for 20 years has paid for health care for low-income children and thereby helped keep them healthy. The program benefits 9 million children whose families earn too much to allow their children to benefit from Medicaid but not enough to buy adequate private insurance for them. Between 1997 when CHIP was enacted and 2015, the rate of uninsured children in the United States fell from13.9 percent to 4.5 percent.

CHIP requires period reauthorization by Congress, which should have taken place in September, 2017. Congress reauthorized the program in early December for a period lasting only until March, 2018.  Now states, which implement the CHIP program, are notifying families that their children soon will be without health insurance.

The problem, Utah Senator Orrin Hatch observed in December, 2017, is that “we don’t have money anymore.”  Together with Senator Ted Kennedy, Hatch had originally proposed the legislation creating CHIP.

Grim health outcomes for U.S. children and mothers reflect political and economic arrangements in U.S. society enabling those in charge to commandeer financial resources that otherwise might have benefited children and mothers. At least one question remains: How did children living in the other OECD nations escape dangers from capitalism evident in the United States?

Part of an answer may lie in the weakened state of working-class forces available in the United States to resist the plunder. Vicente Navarro, a veteran public health investigator and economist, offers some specifics.   He points out that, “The United States, the only major capitalist country without government-guaranteed universal health care coverage, is also the only nation without a social democratic of labor party that serves as the political instrument of the working class and other popular classes. These two facts are related.” Navarro notes the presence of strong labor movements in Europe and labor-union weakness in the United States.

In general, Navarro observes, “If you establish a spectrum of capitalist countries, listing them from very “corporate friendly” (like the United States) to very “worker friendly” (like Sweden), you will find, where the capitalist class is very strong, very poor health benefits coverage (in the public as well as in the private sectors), highly unequal coverage, and very poor health indicators. This is, indeed, the U.S. case.”