Fight is on to lower infant mortality rates
BY CHRISTIN NANCE LAZERUS email@example.com April 4, 2014 7:46PM
Dr. William VanNess, the Indiana State Health Commissioner, talks Friday about ways the State Department of Health has tried to lower the state's infant mortality rate. | Christin Nance Lazerus/Sun-Times Media
Updated: April 4, 2014 9:33PM
GARY — Lake County has one of the highest infant mortality rates in the state — 8.41 deaths per 1,000 live births — but local and state officials are taking action to combat a statistic that represents heartbreak to many families.
Researchers, public health advocates and others presented data and efforts to curb the problem at the inaugural Infant Mortality Conference on Friday at Indiana University Northwest.
Dr. William VanNess, the Indiana State Health Commissioner, said lowering the state’s infant mortality rate is one of his top three priorities, along with lowering obesity and smoking rates. Not surprisingly, the three goals are interconnected, with obesity and smoking contributing to preterm deliveries and low birth weights, which put children at risk of dying, he said.
Indiana ranks 45th in the nation in infant mortality, which is measured by the number of deaths of children before they turn 1.
“This is the No. 1 indicator of health status in the world,” VanNess said. “In Indiana, 16.6 percent of pregnant moms smoke and 30 percent of Medicaid moms smoke. We’re the sixth-most smoking state ... (and) the eighth-most obese state.”
Other leading causes of death include birth defects, SIDS and unsafe sleeping positions, and assault and neglect.
VanNess has been working on the issue by linking pregnant women on Medicaid with smoking-cessation programs, increasing home visits for new moms, and encouraging Medicaid and insurance companies not to cover elective deliveries before 39 weeks unless there’s a medical reason for it.
Community HealthNet executive director Dr. Janet Seabrook discussed the organization’s Centering Pregnancy program, in which eight to 10 women with similar due dates can discuss pregnancy issues and provide support while getting prenatal care.
“A lot of moms have found stability in the group, and we’ve seen a reduction in no-show rates for appointments,” Seabrook said.
The program, which started in November 2012, has seen only one preterm birth, and birth weights are up. Seabrook said the organization is considering creating a Centering Parenting class for parents with newborns to share parenting information and advice.
Racial disparities in terms of birth outcomes are pretty stark, with the black infant mortality rate almost double that of white infant mortality (12.3 to 6.9).
Angela Shields-Wadley, who is the director of case management at Northwest Indiana Healthy Start, said researchers are starting to link the physical stress of racism with an increased risk of preterm labor. African-American women have twice the rate of preterm labor even when they have the same economic and education level as their white peers.
“We’re losing itty-bitty babies before they turn 1, and that’s heartbreaking,” she said.
Dr. Janice Zunich, a geneticist at Indiana University Northwest, said some infant deaths are entirely preventable, particularly those where an infant is accidentally smothered while sleeping on or with a parent in bed or on a couch.
The Back To Sleep campaign has helped to reduce deaths from SIDS since 1994, but Zunich said advocates have tried to add “By Myself” to emphasize the safest way to put baby to sleep.
Zunich sits on the Lake County Child Fatality Review Committee, which investigates deaths for all children under age 18, and in 2012, she said it seemed like four or five children each month had positional asphyxia as a cause of death.
From February 2013 to Jan. 14, positional asphyxia was a leading or contributing cause of death for 20 infants, with an average age of 21/2 months, Zunich said.
“This is something that just really upsets me because I deal with developmental abnormalities that limit a baby’s life span severely, and there’s nothing I can do about it,” she said. “But you see positional asphyxia does not have to happen, and we can eliminate it.”