Articles

Infant Mortality on Decline in State, U.S.

By M.A.J. McKenna
Atlanta Journal-Constitution
June 10, 2005

The rate at which babies die before their first birthday is improving in Georgia and nationally, but African-American children are still twice as likely to die in infancy as children in any other racial group, the Centers for Disease Control and Prevention said Thursday.

In an analysis of birth and death certificates filed nationwide from 1995 to 2002, the CDC's National Center for Health Statistics found that infant mortality — death in the child's first year — is improving across the United States. But the overall improvement conceals some negative trends and is nowhere near as successful as what national public health plans call for.

In 2002, for every 1,000 living children, an average of 7.1 U.S. children of all races died before their first birthday, according to the study. Infant mortality differed sharply among racial and ethnic groups, with a death rate of 5.0 per 1,000 births for Asians, 5.8 for Hispanics, 5.9 for whites, 9.1 for American Indians and 13.9 for blacks.

Overall, the CDC said, the national rate of infant mortality was 11 percent lower in 2002 than in 1995.

Georgia's overall rate was higher that the U.S. average, at 8.7 per 1,000 live births. And as reflected nationally, infant mortality varied among races: The rate was 6.0 per 1,000 for Asians, 5.9 for Hispanics, 6.2 per whites and 13.8 for blacks.

Dr. Stuart Brown, newly named director of the Georgia Division of Public Health, said the state's improvement in infant mortality exceeds the national trend. The rate sank by 15 percent between 1993 and 2004, he said, using numbers from a broader span of years than those used by the CDC.

"Infant mortality is something there has been a fair amount of energy and effort put into," said Brown, who was previously acting director of the DeKalb County Health District. "The biggest problem remains low birth weight and prematurity, and those are strongly influenced by health and lifestyle, and access to prenatal care."

Georgia is examining ways to increase prenatal and newborn care in community health centers, as well as creating a corps of public health nurses to do prenatal and infant visits, Brown said.

The state and national rates released by the CDC are nowhere close to the federal list of health goals, called Healthy People, which calls for a reduction in infant mortality nationally to 4.5 deaths per 1,000 births by 2010.

The United States has higher infant mortality rates than many industrialized countries; the current rate per 1,000 births is 2.4 in Sweden, 4.5 in France and Germany, 4.8 in Spain and 5.8 in the United Kingdom, according to the World Health Organization.

Infant mortality remains a stubborn problem in the United States for two linked reasons, said Dr. Carol Hogue, Terry Professor of Maternal and Child Health at Emory University's Rollins School of Public Health.

American women have a higher rate of unplanned pregnancies than women in other countries. Unplanned children — who often come late in the mother's child-bearing years — tend to receive less prenatal care and run a greater risk of complications at birth.

And across the country — but particularly in rural areas — up to 50 percent of high-risk pregnancies are not delivered in specialized centers that could do more to save newborns' lives, Hogue said.

Copyright 2005 The Atlanta Journal-Constitution. For more information, visit www.ajc.com.

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