Thursday, June 21, 2007

Infant Mortality Up

NPR reports that the infant mortality rate in some Southern states (specifically Mississippi) is on the rise:

The most recent statistics show Mississippi had the biggest increase in the number of babies dying in their first year of life.

Historically, the state has had a higher infant-mortality rate than most of the country. But between 2004 and 2005, the number of babies dying in the state increased almost two points — to 11.4 deaths per 1,000 births.

No one seems to know exactly what the cause is, but there appear to be several contributing factors:

[Social worker] Johnson says even though Brown is on Medicaid and considered high risk, she can't see a specialist. "It's so rural that women have to travel 36 to 40 miles one way to see a doctor," Johnson says. "When they go in, patients see a nurse practitioner. They see a physician in the eighth month [of pregnancy]."

Another problem, according to Johnson, is that many doctors in rural areas do not accept Medicaid.

To apply for Medicaid, women now need an original birth certificate, and they must appear in person. Many critics say this new policy is preventing women and babies from getting the medical care they need.

Race is another factor that contributes to the higher infant-mortality rate in Mississippi and the rest of the South. Nationally, black mothers are twice as likely to lose their babies as white mothers, and in Mississippi, about half of all babies are born to African-American women.

Even well-educated, affluent black women are more likely to have problem pregnancies than their white counterparts, but it's not clear why.

What can be done about it?

Getting high-risk women medical and prenatal care when they are pregnant is not enough, Dr. Brann says. Medical experts should also monitor women between pregnancies to make sure they stay healthy and take care of any ongoing medical issues. A pilot program launched in Atlanta is addressing this need.

The cost of providing ongoing medical care for these women is about $2,000 a year. The cost of treating babies born prematurely — some with severe health problems — is tens or hundreds of thousands of dollars per child. Many never leave the hospital.

And why should we do this?

Sandy Reynolds' son, Jeremiah, weighed just 1 pound, 15 ounces when he was born. He lived 11 months in a neonatal intensive care unit in Jackson, Miss.

Reynolds and her husband spent at least three days a week with their son.

"We dressed him up for Halloween and we had Christmas with him," she says. "We never treated him like he was a sick baby."

But Jeremiah's underdeveloped lungs were so susceptible to infection that he died the day after Christmas last year, without ever going home. Reynolds still grieves.

"God gave us 11 months, and I don't take back any of that time, because we enjoyed every day that we went with him," she says.

This is the fourth child she has lost in 12 years.

If that doesn't break your heart, then you're not human.

I could launch into an anti-Bush screed here at this point, but the truth is problems like this are the fault and the responsibility of all of us. Poor people have enormous hurdles to overcome, but they have to be motivated to overcome them. Public health experts need to study this issue and inform the public as to possible solutions. We all need to understand that there's really no excuse for infants to be born too soon, or sick, or die as a result of a lack of health care for their mothers. This is only one symptom of the terribly inequitable state of health care in this country today, but it's perhaps the most tragic of all.

UPDATE: Here's some context for those numbers above, from Heather Hurlburt at Democracy Arsenal:

Mississippi's rate, 11.1 deaths per thousand babies, is worse than post-Communist states like Hungary and Poland, and Latin American countries like Costa Rica and Chile, all of which have lower per capita incomes. What country most closely matches Mississippi's rate, I wondered while listening to the story? So I went and looked it up.


Yeah, it's that bad.

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