Thursday, March 31, 2011

Circumcision & poor health outcomes in 1st world nations

There is much evidence that infant circumcision contributes to poorer health outcomes in first world nations.

Health Outcomes in Children

Firstly, A recent Australian (2009) research found that present day Australian Children had far superior health outcomes to when routine infant circumcision was common, read as follows:

"The health of Australia’s children continues to improve, according to the latest report on child health from the Australian Institute of Health and Welfare, A Picture of Australia's Children 2009. During the period 1986-2006 there was a dramatic decline in infant and child deaths (which fell by half), improved survival in cases of cancer, and a reduction in the incidence of asthma.
These are significant findings, given that the period 1986 to 2006 witnessed a huge decline in the incidence of circumcision, from about 40 per cent of boys in the early 1980s to about 10 per cent in 2006. It is thus good empirical proof that “lack of circumcision” does not increase child health problems. Even more significantly, it is a decisive refutation of “scientific” predictions by Terry Russell, Brian Morris and other diehard promoters of routine circumcision that the fall in the circumcision rate would lead to an explosion of genito-urinary problems in boys and an ever-increasing death toll from urinary tract and bladder infections. No such problems are identified in this report, which does not even mention any health problems affecting the genito-urinary area.
On the contrary, the halving of the death rate among infants and children suggests that leaving the foreskin in place could even have significantly improved child health outcomes and contributed to the decline in infant and child mortality. It is, after all, quite illogical to claim that a boy with wound on his penis is somehow healthier than a boy who has not been injured there. As the British child health expert N.R.C. Roberton points out, “it is fundamentally illogical that mutilating someone might be beneficial.” *
Problems identified by the AIHW report include an increasing incidence or diabetes and obesity, more, tooth decay, too much television, not enough vegetables, and persistent poor health among indigenous Australians. It is hard to see how even a fanatic like Brian Morris could blame “lack of circumcision” for children not eating their vegetables.
The Australian Institute of Health and Welfare is the Australian Government’s premier health research foundation.
The full report and press release can be downloaded from the AIHW website.
N.R.C. Roberton, “Care of the Normal Term Newborn Baby,” in Textbook of Neonatology, eds. Janet M. Rennie, N.R.C. Roberton, 3rd edn. (Edinburgh: Churchill Livingston, 1999), 378-379.


When we look at longecity of first world nations an interesting story emerges.  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 (Circumcision Culture) 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 dont circumcise are the longest lived USA citizens. Therefore it is very clear that Infant Circumcision fails 1st world nations on the health measure of Longevity.

Infant Mortality

Infant mortality is another measure of public health, and the USA (The largest circumcising 1st world nation) 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 first world circumcising nation of USA on the health measure of Infant Mortality.

UN Child Well-Being Measure
Infant circumcision has also failed circumcising America on a UN measure of child-well being:

United Nations measure of child well being = look at the table below:
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.

Sexually Transmitted Infections is another measure of Public Health where infant circumcision has failed the Circumcision USA when compared to Non-Circumcision nations of Europe.  The USA has 6 times the HIV infections than No-Circ Germany & 3 times the 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.

Penile Cancer

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.

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 & Japan which dont circumcise their male infants, have healthier infants, boys, and men, than the USA which does circumcise its infants.  On these 5 measures alone 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 first world medicine nation of the USA.

In summary, At the very least, and against its own claims "that infant circumcision provides health benefits", infant circumcision has failed the first world nation of America, and Non-Circumcision Cultures do better. 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 limited health resources to do this research, and circumcision nations would be averse to devoting limited health resources 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 first world nations like America where ordinary people through education and a willingness to go against cultural norms, and by protecting one baby at a time from infant circumcision, that will eventually see the practice abolished in all first world nations.

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

1 comment:

  1. Thank you Ian Wilkinson for this telling conglomerate of information. It's very compelling sure to make parents think better.