More research needed on growing disparity between white, black infant death rates, experts say

Black Issues in Higher Education, June 17, 2004

CHICAGO

When Nakida Maxson was pregnant, some of her friends teased her about going to birthing classes and taking prenatal vitamins, saying they were things only White people did. Maxson, who's Black, ignored her friends.

"It's not a White people thing, it's a child thing," Maxson said. "For your child, you need to make sure that certain things are taken care of."

She is determined to not become part of a troubling statistical trend in Illinois: The rate of Black babies who died before their first birthday increased in 2002 to 15.7 per 1,000 live births, even as the overall infant mortality rate fell to an all-time low of 7.2 deaths. The rate for Whites was 5.5.

Nationally and in Illinois, the infant mortality rate for Blacks and Whites has decreased significantly over the past two decades, but Black babies are still twice as likely to die as White babies. And the disparity is growing.

Health experts say cultural viewpoints about pregnancy and child rearing are among the factors responsible for the disparity, along with access to health care, income and perhaps even racism.

Reaching at-risk women is one of the keys to reducing the problem.

The Illinois Department of Public Health oversees programs that help more than 100,000 low-income women each year with prenatal care at hospital clinics, food vouchers, counseling and other services.

The state plans a new campaign this summer, with the help of federal dollars, to reduce Sudden Infant Death Syndrome (SIDS) among Blacks and provide more care to women who previously had premature births.

Doctors say more than half of all infants who die each year are born early and have a low birth weight. Black women are known to have a higher risk of delivering prematurely and to have babies with low birth weights. Black infants also face a much higher risk of SIDS.

"We do know what helps is to make sure that all high-risk women are located and that we get them hooked up with a doctor, make sure they get good prenatal care and that any medical conditions may be identified," said Dr. Stephen Saunders, associate director of family health for the state's Department of Human Services.

At the Southern Illinois University School of Medicine hospital in Springfield, some low-income mothers from central and southern Illinois don't go to regular checkups because they have to travel up to 40 miles to get to that hospital since doctors in their area don't accept Medicaid, said Dr. Victoria Nichols-Johnson, a professor of obstetrics and gynecology at the school.

Dr. Dick David, a neonatologist at the John H. Stroger Jr. Hospital of Cook County in Chicago, said the government must do more to increase outreach in the Black community and to improve women's access to health care before and after their child is born. Generally low-income women are covered under Medicaid only during their pregnancy.

"The strategy for improving infant mortality in the United States is one that makes perfect sense for people who are already well-nourished, are already getting basic care, have a good place to live, etc.," David said.

Some researchers have pointed to factors such as living in high-crime areas and racial discrimination.

"It's racism. This increased risk of premature birth is related to the way the body reacts to social stress, or racism, in everyday life," David said.

Experts say more research is needed on the confounding disparity even as they try tactics to erase it.

"There is no silver bullet," David said.

--Associated Press