Report: Uphill climb for Gary’s black babies growing steeper
By Teresa Auch Schultz firstname.lastname@example.org May 18, 2013 11:30PM
Japhia Patton kisses her 6-week-old baby Saraji in her Gary, Ind. home Thursday May 9, 2013. Patton has participated in a support group for pregnant mothers, first-time and those already with children, through Community HealthNet. | Stephanie Dowell~Post-Tribune
By the numbers
The State of the Black Youth report shows that several health factors for black babies in Gary have gotten worse in the past decade, including:
Premature babies: 12 percent in 2004, 16.2 percent in 2008
Low birth weight babies: 13.9 percent in 2004, 15.4 percent in 2008
Mothers receiving prenatal care during first trimester: 52.4 percent in 2007, 48 percent in 2008
Mothers who smoked during pregnancy: 12.6 percent in 2004, 12.6 percent in 2008
Infant mortality rate per 1,000 live births: 16.9 in 2004, 13.5 in 2008
Chlamydia cases per 1,000 teens 15 to 19 years old: 91.6 in 2006, 110.3 in 2011
In Lake County
Numbers from the March of Dimes show similar trends continuing in 2010 for all babies across Lake County:
Premature babies: 14.6 percent in Lake County, 11.8 percent in Indiana
Low birth weight babies: 9.5 percent in Lake County, 8 percent in Indiana
Mothers receiving prenatal care during first trimester: 66 percent in Lake County, 68.9 percent in Indiana
Infant mortality black children: 13.2 percent in Lake County, 15.4 percent in Indiana
The Indiana Black Expo wants to know how black children in the state are doing.
From ISTEP-Plus passing rates to children living in poverty to teen girls giving birth, Black Expo has tracked more than 50 factors to see the overall quality of life for black Hoosier youths. The group released its third report on these statistics in December, five years after its second report was released and seven years after the first. The report includes not only information on children across the state but also children in several communities, including Gary.
The Post-Tribune is taking a look at the various areas the Black Expo studied to see how life has improved — or gotten worse — for black children in Gary.
Updated: June 20, 2013 4:06PM
GARY — When Japhia Patton’s nurse midwife suggested she try a new way of attending her doctor’s appointments for her pregnancy with her fifth child, the Gary woman was at first apprehensive.
The midwife, Leah Staples with Community HealthNet in Gary, asked the married mother to join a new support group called Centering, in which she would join other women at a similar stage of pregnancy.
“I was really nervous the first time,” Patton said, adding that she wasn’t sure how comfortable she would feel being around other women during her checkups.
But after the first meeting, Patton was sold on the idea. The group became a way for her to let off steam, commiserate with people going through the same experiences and learn new healthy habits that even this experienced mom didn’t know.
Now Community HealthNet officials and other Lake County health advocates hope to use this and other methods to fight was is becoming an alarmingly growing rate of unhealthy black babies in Gary.
According to the State of the Black Youth study by the Indiana Black Expo, black children in Gary are more likely than black children across the state to be born prematurely or at a low weight. The numbers are increasing for Gary babies, too, with the number of low birth weight babies increasing from 13.9 percent in 2004 to 15.4 percent in 2008, and the numbers of premature babies increasing from 12 percent in 2004 to 16.2 percent in 2008.
More recent data from from the March of Dimes for Lake County show that the trends likely haven’t gotten any better, as numbers for the county in those and other categories continue to remain above the state average.
Lake County is one of only two counties in Indiana (joined by Marion County) that the March of Dimes provides specific information on.
“That’s how bad we are, that the national organization actually drills down that far,” said Victor Garcia, division director of Northwest Indiana for the March of Dimes.
The rates are worst for the black and Hispanic populations, Garcia said. Although genetics can play a factor, so does poverty. Garcia said about 60 percent of live births are paid for by Medicaid.
Getting Medicaid — or even knowing if you’re eligible for Medicaid — is a big road block for some pregnant women, said Leah Staples, midwife for Patton and others at HealthNet in Gary and leader of the Centering group. The health center acts as a Medicaid enrollment site and can even start providing services before a patient is approved, which can take months, but many pregnant women don’t know that.
“They don’t understand there is a place they can go to and be seen before fully approved,” Staples said.
Dr. Janet Seabrook, executive director of HealthNet, said the economy hurts pregnant women in other ways. Mothers in economic straights often have trouble finding transportation to their doctors appointments, whether from lack of a car or a poor bus system. Medicaid can provide payment for transportation, but even those services have their own problems. Patients usually have to reserve a ride more than a day in advance, and the drivers won’t continue after 4 p.m.
Then other people often move between Northwest Indiana, Chicago and Indianapolis, meaning they have no dedicated health care provider and often see one only infrequently.
“When they fall in our doors, we take care of them, but it’s not through the group and it’s very sporadic,” Seabrook said. “We never know where they’ll deliver.”
Perhaps Gary’s biggest problem, however, is the number of teen mothers giving birth. Young women and girls are at higher risks for premature and low weight babies, Seabrook said, and often don’t have the knowledge of how to properly take care of themselves during pregnancy, such as eating right. They can also often lack a support system at home.
“You’re not really ready to do that at age 14,” Seabrook said. “... It’s just a whole myriad of things that go with it.”
Teens are also more likely to be at risk for a sexually transmitted disease and to not seek treatment for it. That disease can then cause issues with their pregnancy, Seabrook said.
March of Dimes and HealthNet are trying to combat the issue through the Centering group, which the March of Dimes has funded. Started in November, the Centering groups aim to bring 12 to 15 women with similar due dates together about once a month. The women meet at HealthNet in a yellow room decorated with a dozen poster boards focusing on various topics of pregnancy. A circle of rocking chairs dominates the middle of the room, and a curtained-off bed sits in a corner.
The idea behind Centering, which is popular at clinics in Indianapolis, is to provide early and continual support to pregnant women. The women check their own weight and blood pressure at each meeting, recording it in a journal, before they go behind the screen, one by one, for their check up with Staples as music plays in the background.
After Staples has seen everyone, the women all write down what they want to talk about that day.
So far, HealthNet has recruited women for the group by looking for patients who could benefit and then approaching them about trying something new at their next appointment.
“We tricked them because nobody had a clue what Centering was,” Seabrook said of the first group, which started meeting in November.
Patton was a member of that group and although she was reserved about attending that first meeting, she knew by the end she loved it.
“The group gives you answers that you want to know that you don’t know,” Patton said. “I’m going on five kids and I’m like, I didn’t know that.”
Although a few other women in the group already had children, Patton said, most were first-time mothers of various ages and backgrounds. The group allowed the women to discover similar interests and to support each other through the ups and downs of pregnancy.
“You’re around somebody else who’s going through what you’re going through,” she said.
Patton said the group learned at its first meeting about the importance of healthy eating, something that Patton said she tried to stress to the other moms. But even Patton said she realized during the group that she didn’t know everything, such as when women are most likely to conceive.
“It was a lot of stuff that a lot of us were shocked to hear, even with those who have kids,” she said.
The biggest benefit of the group for Patton, however, was the sense of camraderie. Patton said the women checked in with each other and that she would offer to drive some of the other members who didn’t have cars. Other times Patton could talk about the stress, which is believed to play a role in premature births, she was under.
“I wish this group would have formed when I had my other kids because I was under a lot of stress, and I didn’t know what to do with and just held it in,” she said.
HealthNet has started two other Centering groups and hopes to continue expanding the group now that it has secured money for another year. HealthNet also wants to reach certification for Centering, which will allow it to use all the Centering’s educational items and hopefully make it easier to attract even more funding.
Seabrook said she wants to see Centering groups at all of Community HealthNet’s sites in Lake County and that the group is already hearing from people who, hearing about the group from friends who took part, now want to join in too. She stressed that the money spent on providing healthcare to these women now will pay off in the long run by keeping babies out of neonatal intensive care units, which can cost up to hundreds of thousands of dollars for long-term stays.
“When you think about the cost savings, if we’re able to keep one infant, just one, out of the NICU, we’ve saved a lot of money for the community,” she said.
The health clinic is also preparing to start the next chapter of Centering, this time for parents of newborns. The groups will hopefully include the women who joined the Centering pregnancy groups, Seabrook said, and help them learn parenting skills through the first year of their child’s life.
But spreading this and other group efforts requires educating the community, Garcia said.
That’s why the March of Dimes is also working on another effort, called Health Baby, Healthy Business, to reach out to local businesses about providing information for free to employees through a company’s intranet website. The group is also lobbying downstate to get more support for prenatal care coverage for women, he said. March of Dime’s goal is to lower premature births by 8 percent by next year.
And in some ways, the healthcare community in Gary and Lake County has already seen some success. Infant mortality has actually gone down for black babies born in Gary, according to the Indiana Black Expo report, from 16.9 percent in 2004 to 13.5 percent in 2008, which puts Gary below the state average. Data from the March of Dimes shows that success continued to 2010, when Lake County 2 percentage points lower than the state average for black babies.
“I’m very excited to do what I do, but I also hope one day to have to go and find another job,” Garcia said.
Despite all the efforts, Seabrook said she doesn’t expect to see huge gains happening at once. Instead, a solution will come when the community can gather to address all the varied issues that pregnant women face.
“It’s nice to have a big success, but typically it doesn’t happen like that,” she said. “You have small bites, and it keeps growing.”
And even though the Centering groups have proven popular with the women picked to join them, premature births still happen. Patton was due to give birth to her daughter, Saraji, on April 13, but the baby came early on March 29. Even though she was the biggest of Patton’s five children, at 5 pounds and 12 ounces, she is still considered a premature baby, Patton said.
That, even though Patton ate healthy food, never smoke or drank and followed everything else she learned in Centering.
“I did everything, but it can still happen,” she said.
The mother doesn’t let it get her down, however, and notes that Saraji, who was in NICU for just a few days, can already hold her head up and can push herself up on her arms. Patton said she would love to see the group grow and knows that many other women could benefit from it.
“There’s a lot of people out there who need it, who may not know they need it, but it’s going to work for them,” she said.