Infant mortality in Delaware County increased from 7.4 to 9.6 per 1,000 births from 2008 to 2013. It disproportionally impacts Black babies with over triple the infant mortality rates. A major contributing factor is the under-utilization of prenatal care supports among Black mothers.
Data from the Public Citizens for Children and Youth (PCCY) Wellness Index shows that in 2014, 43 percent of Black women started prenatal care in the first trimester, compared to 72 percent of white women. Mothers who receive late (defined as beginning in the third trimester of pregnancy) or no prenatal care, are more likely to have babies with health problems.
The U.S. ranks 56th in the world for infant mortality with 6.1 deaths per 1,000 births; Delaware County is above Pennsylvania’s rate of 6.7 with 9.6 deaths per 1,000 births.
The data was gathered from the Pennsylvania Department of Health accounting for every live birth and every death from 2008 to 2012. Infant mortality is defined as the death of a baby before his or her first birthday. This rate is often used as an indicator to measure the health and well-being of a nation, because factors affecting the health of entire populations can also impact the mortality rate of infants.
“How kids come into this world, what their health status is, if we are not able to sustain their life, I think it’s a very large statement about our ability to care for each other, especially our most vulnerable,” said Colleen McCauley, PCCY Health Policy director. “The kids who tragically die are mostly minority or low income. Delco has a higher share of individuals and families living below the poverty line. We are making strides and a variety of programs and resources and programs in place to help stem this tide.”
The Public Health Management Corporation created a Perinatal Period of Risk (PPOR) presentation which aims to reduce fetal and infant mortality by helping communities identify and prevent risk factors during the greatest periods of risk. The results show the health of the mother is a major factor in fetal and infant deaths.
Black women are three times more likely to have a fetal or infant death, five times more likely to have a baby before 24 weeks, and are almost two times more likely to have a low birthweight baby compared to white women.
The majority of excess deaths are in the maternal health and prematurity category, which points toward risk factors associated with preconception health. Potential risk factors identified at this point: hypertension, pregnancy spacing, low weight gain, and clinical presentations.
Joanna Craig, project director and principal investigator for the Healthy Start grant for which PHMC is the contacted evaluator, says preconception health and well-being, including stable housing, no risky behaviors, low stress, are key factors. She noted the PPOR study is not complete and is in Phase Two which requires more analysis.
Infant mortality is not only a concern for new mothers or mothers-to-be.
“Resources have to be devoted to the sickest kids and these services have to be paid for. To pay for them, very often, our taxes go up. We are all impacted. These kids who die in infancy, it impacts us all. Good public policy is key,” said McCauley.
“Children are at the beginning of population and society. One baby dying is one baby too many especially when so much can be prevented. When babies are born sick they require many interventions and they are often publicly funded. If we can educate women of childbearing age of the importance of taking care of themselves before they get pregnant, and in between pregnancies, they will do the things they need to do that will contribute and support good birth outcomes. If you can have a good birth outcome we stand a big chance of babies making it to their first birthday and beyond,” added Craig.