Wednesday, February 9, 2011

Has circumcision been successful or a failure in America?


Lets examine whether Infant circumcision has succeeded or failed America?  Americans have claimed they perform infant circumcision because it has health benefits, so lets examine health benefits via examining real life epidemiological outcomes.

Longevity is universally recognised as one of the most important signs of the health of an individual and the individuals of a nation, if we look at Americans Longevity which is 78yrs, you would expect it to be higher than similar nations that do not practice Circumcision, but in fact the opposite is true. Countries that do not circumcise have much higher longevity.  Japan’s  Longevity is 81.4yrs, Sweden’s Longevity is 80.6 yrs, Switzerlands Longevity is 80.6years. In fact most of Europe which does not Circumcise has higher longevity than the USA. Even within the USA it has been reported in Press that American Latino's who generally circumcise the least are the longest lived USA citizens. Therefore it is very clear that Infant Circumcision has failed the USA on the health measure of Longevity.

The Latest OECD report on the medical health of nations lists the the top 30 countries with rankings 1 being best outcomes and 30 the worst reads as follows: Let's start off by considering the health category, since healthcare is very much in the news in the US, and what's happening with it now so richly illustrates the value of Fullbrook's austere marshalling of stubborn facts.  The indicators in this category, along with the United States' ranking, are as follows: life expectancy at birth (24), healthy life expectancy at birth (24 [tied] out of 29), probability of not reaching the age of 60 (25), infant mortality rate (25), obesity (30), practicing physicians per capita (23), acute care hospital beds per capita (25 out of 29), psychiatric care beds per capita (25 out of 29).. On the combined index of health care indicators, the US comes in at 28, just ahead of ... Turkey and Mexico. You would have to agree that if cirumcision is a predictor of health, then it fails miserably in this context, as most nations ranked higher than the USA do not routinely circumcise their males.

Infant mortality is another measure of public health, and the USA does very poorly again compared to its no-circ peers, with much higher infant mortality than the EU nations & Japan.  The USA infant mortality rate is 6.4 deaths per live births, versus Sweden 2.8 deaths per live births  at and Japan at 3.2 deaths per live births. Again most of non-circumcising Europe has lower infant mortality than the USA.  Infant Circumcision has failed the USA on the health measure of Infant Mortality. 

Death from infant circumcision.  Tragically, Babies die unnecessarily every year in the USA from the complications of circumcision.  This is irrefutable evidence, that when babies die from a preventable death, because infant circumcision is an elective procedure, that it is failing America.

Infant circumcision has also failed America on a UN measure of child-well being:

United Nations measure of child well being = look at the table below:
CHILD WELL-BEING TABLE
1. Netherlands
2. Sweden
3. Denmark
4. Finland
5. Spain
6. Switzerland
7. Norway
8. Italy
9. Republic of Ireland
10. Belgium
11. Germany
12. Canada
13. Greece
14. Poland
15. Czech Republic
16. France
17. Portugal
18. Austria
19. Hungary
20. United States**
The 19 Nations ahead of the USA** are all non-circumcising nations.  From this evidence alone it appears than circumcising infants makes zero contribution to child well-being.  This data would suggests there are other factors far more important than circumcision which are involved in child well-being, and that infant circumcision has zero contribution to child well-being.
(http://www.un.org/apps/news/story.asp?NewsID=21566&Cr=unicef&Cr1)


Sexually Transmitted Infections is another measure of Public Health where infant circumcision has failed the USA when compared to Non-Circumcision nations of Europe.  The USA has 1200% higher HIV infections than No-Circ Finland (in Press) has 500% higher HIV infections than No-Circ Germany & 300% higher HIV infections than no-circ Holland.  .  The USA has 2.7 times the Syphillus infections than than no-circ Holland. .  The USA has 33 times the Gonnoreah infections than than no-circ Holland.  .  The USA has 19 times the Chlamydia infections than No-Circ  Holland.  Infant Circumcision has failed the USA on the health measure of STI Infection rates.
 (Advocates for Youth data) http://www.advocatesforyouth.org/storage/advfy/documents/fsest.pdf


Another claim by Circumcision proponents is that circumcison prevents penile cancer. Denmark which doesnt circumcise its male infants has lower penile cancer rates than the USA which does. This epidemiological finding suggests there are more important factors than circumcision to preventing penile cancer. Another fail for infant circumcision.

Male anger at infant circumcision is seen in the foreskin restoration movement and the huge Intactivist movement in the USA.  That men are restoring their foreskins after being involuntarily circumcsed is more evidence of circumcision's failure.

In medical epidemiology we often look to world's best health outcomes, identify the resasons/practices which contribute, and often label this as the gold standard medical practice.  Europe which doesnt circumcise its male infants, has healthier infants, boys, and men, than the USA which does circumcise its infants.  Non-Circumcision of infants would be considered Gold Standard Medical practice, and it could be said that Infant Circumcision as a public health measure, is one big monumental failure in the USA.

In summary, At the very least, and against its own claims "that infant circumcision provides health benefits", infant circumcision has failed America, and if anything one could speculate that the data indicates a correlation with the very opposite (infant circumcision causes poorer health outcomes in first world nations).  However, much further detailed and more expensive research would be required to determine the validity of the correlation between infant circumcision and poorer health outcomes in first world nations.  Non-Circumcising nations would have zero motivation to allocate resources to this research, and circumcision nations would be averse to devoting reseources to find out that their religious & cultural medical practice is actually harmful to male health. In essence as is the case now, it is a grass-roots movement in America where ordinary people through education and a willingness to go against cultural norms, by protecting one baby at a time from infant circumcision, that will eventually see the practice abolished in the USA.

The onus is on the promoters & profilgators of circumcision to prove otherwise, but on these true life medical outcomes infant circumcision has failed America.

The World Health Organisation 2007 is the source of Longevity and Infant Mortality data.  Advocates for youth is the source of STI data:

http://www.advocatesforyouth.org/storage/advfy/documents/fsest.pdf

6 comments:

  1. While I agree that circumcision is pretty close to useless for most of the benefits stated by pro-circ people, I don't see that these data points really indicate that circumcision is the driving force behind the result.

    HIV infection in the US, for example, has a lot more to do with sharing needles than it does with sexual intercourse.

    There are also a slew of cultural differences that affect longevity, infant mortality, and child well-being that are not being taken into account.

    It's like drawing a conclusion about alcoholism by number of people that own parkas in a country, without considering that this would be heavily influenced by the climate of the country.

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  2. "The USA infant mortality rate is 6.4 deaths per live births, versus Sweden 2.8 deaths per live births at and Japan at 3.2 deaths per live births"

    "per *thousand*", I hope you mean.

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  3. This data shows that circumcision is not necessary to excellent health, although since each country is different, there are probably a lot of factors that affect the numbers.

    Personally I would want a LARGE OBVIOUS benefit before cutting off a part of my own body. It would have to be even more glaringly necessary before I would cut off part of my child's body.

    What is the data on UTIs, since that is the only supposed benefit that would help an infant...all the others are risks that come later in life (HIV, cancer, etc.).
    Now that rates in western states are dropping fairly low, one could even do comparisons within the US.

    I don't believe there are any overall benefits to circumcision, but the more obvious and plain data we can come up with for people "on the fence", the better.

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    1. I'm not sure what UTI data is. One study which showed 10x lower UTI's in circumcised babies has been stringly criticised for its methodology, saying that improper intact care such as retracting babies foreskins may have contributed to higher uTI rates. Another Japanese study which examined infant health foung zero UTI's in a cohort of Japanese infants which are not circumcised. I would say there is zero evidence to use circumcision to prevent UTI's, which are mostly easily treatable.

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  4. NOVOGLAN:

    Putting aside religious and cultural reasons for circumcision (as these are abhorrent at best) the suggestion that pan-prophylactic amputation should be considered normal is clearly unethical.

    Education, especially of mothers, and the provision of quality condoms for all sexually active people would deliver better outcomes for humanity, keep people safe, and provide an ethical approach to disease prevention.

    The scientific method and robust review and retesting is paramount to delivering the truth and informing decision makers. However, as Ian rightly points out that modern science can be expensive and barriers to inquiry exist everywhere, especially on topics such as male genital mutilation (aka Circumcision).

    For our part - Novoglan is committed to providing both safe alternatives to circumcision for men and too better educating mums and dads about the role of the foreskin and good health.

    We at NOVOGLAN encourage the debate and also seek review of our online material to ensure it is balanced and reflects the current state of knowledge - please drop us a line at http://www.novoglan.com/contact-us - we support people and entities that promote ethical approaches to human health and well being and challenge dogma and religious and culturally based (usually stone age) approaches to human health.

    Keep up the good work! NOVOGLAN Team Sydney

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