A society’s infant mortality rate is an accepted indicator of that society’s general health status.
Given that ...
Infant mortality rate is treated as an indicator of society's general health status, and that ... the U.S. infant mortality rate has been steadily declining,
How can it be that ...
Babies in the U.S. aren't necessarily healthier at birth than they were in the past?
Evaluate
Usually on Paradox questions, the background comes first and the surprise comes second, but not always.
In this case, it might feel more natural to think, GIVEN THAT babies in the U.S. aren't any healthier than before,
HOW CAN IT BE THAT the rate of babies dying has gone down in the U.S.?
Goal
Let's look for a way to explain fewer babies dying, even though the babies aren't inherently healthier than before.