Warning sign: infant deaths rising in the South
Infant mortality -- babies dying in their first year -- is considered a "bellwether" health issue by public health experts. A tragedy in and of itself, growing numbers of babies dying also signals a stress on the overall health of a community or region, being closely linked to other health problems like hypertension and obesity, and correlated strongly with poverty and larger "stressors."
That makes the recent news reported in the New York Times especially disturbing, that infant mortality rates in the South -- after years of stabilization or decline -- are now on the rise:
For decades, Mississippi and neighboring states with large black populations and expanses of enduring poverty made steady progress in reducing infant death. But, in what health experts call an ominous portent, progress has stalled and in recent years the death rate has risen in Mississippi and several other states. [...]
"I don't think the rise is a fluke, and it's a disturbing trend, not only in Mississippi but throughout the Southeast," said Dr. Christina Glick, a neonatologist in Jackson, Miss., and past president of the National Perinatal Association.
To the shock of Mississippi officials, who in 2004 had seen the infant mortality rate - defined as deaths by the age of 1 year per thousand live births - fall to 9.7, the rate jumped sharply in 2005, to 11.4. The national average in 2003, the last year for which data have been compiled, was 6.9. Smaller rises also occurred in 2005 in Alabama, North Carolina and Tennessee. Louisiana and South Carolina saw rises in 2004 and have not yet reported on 2005.
Infant deaths are also a product of racial inequality:
Most striking, here and throughout the country, is the large racial disparity. In Mississippi, infant deaths among blacks rose to 17 per thousand births in 2005 from 14.2 per thousand in 2004, while those among whites rose to 6.6 per thousand from 6.1. (The national average in 2003 was 5.7 for whites and 14.0 for blacks.)
Why the rise? The story looks at a number of contributing factors; one of the most obvious is the undermining of state-based Child Health Insurance Programs (CHIP). For example, here's what's happened in Mississippi:
In 2004, Gov. Haley Barbour came to office promising not to raise taxes and to cut Medicaid. Face-to-face meetings were required for annual re-enrollment in Medicaid and CHIP, the children's health insurance program; locations and hours for enrollment changed, and documentation requirements became more stringent.
As a result, the number of non-elderly people, mainly children, covered by the Medicaid and CHIP programs declined by 54,000 in the 2005 and 2006 fiscal years. According to the Mississippi Health Advocacy Program in Jackson, some eligible pregnant women were deterred by the new procedures from enrolling.
The NY Times story doesn't look at the international picture, which helps put the issue in perspective. The U.S. has one of the highest (if not the highest) infant mortality rates in the industrialized world; at least 20 countries rank ahead of the U.S. Which points to another possible factor: the U.S. is the only industrialized country without a national health program.
Chris Kromm is executive director of the Institute for Southern Studies and publisher of the Institute's online magazine, Facing South.