ALARMING LOSSES: COLUMBUS WORKS TO REVERSE TRENDS IN INFANT DEATHS
It is a family’s horror and our community’s shame. Babies born in some parts of this city die at rates […]
It is a family’s horror and our community’s shame. Babies born in some parts of this city die at rates the nation as a whole hasn’t seen in 50 years. And black babies in Ohio are more likely to die before their first birthdays than anywhere else in the nation. Through the first half of this year, with 81 babies gone, we face another year in which we see three lives a week end in Franklin County before they’ve barely started. The rate of infant deaths here — 7.7 per 1,000 last year — signals trouble that goes beyond lives lost. It is evidence of broader weaknesses in our community, of areas where the challenges that pile up at people’s doorsteps make Columbus a hard place to start life, say public-health experts and others who are pushing for change. >> See more photos “It is our responsibility to protect our children,” said Dr. Arthur James, an infant-mortality expert and obstetrician-gynecologist at Ohio State University’s Wexner Medical Center. “We have to have courage to figure out how to protect and save our babies.” These losses touch all of us — black and white, moms with graduate degrees and teens who hide growing bellies from their parents. But much of infant death is tied to race and place. The Franklin County babies who died in the first half of this year were born to families of all races but were disproportionately black: 43 were black; 31 were white. The others were Latino, Native American, Asian Indian, Middle Eastern or biracial. Eight neighborhoods have emerged as homes to the highest concentration of the 770 infant deaths in Franklin County in a five-year span. The “hot spots” are scattered throughout the city — southeast, northeast, near south, near east, Morse/161, South Linden, the Hilltop and Franklinton. (The areas are based on census tracts, not official neighborhood boundaries.) These areas are home to 22 percent of the babies who die (and 30 percent of the non-white babies), though they include just 9 percent of the county’s residents and about 12 percent of births, according to Ohio State University’s Kirwan Institute for the Study of Race and Ethnicity. The institute is analyzing data for the Greater Columbus Infant Mortality Task Force, a group of community leaders who began working this year on plans to improve the outlook for babies born here. South Linden is the worst off, with a rate of 23.5 infant deaths per 1,000 live births between 2007 and 2011. That’s almost three times the county’s rate of 8.6 for the same time frame. The Near East Side (18.4) and the Hilltop (17.1) are home to the second- and third-worst pockets, respectively. South Linden is 72 percent minority (mostly black). Forty-three percent of its population lives in poverty. And it has a high rate of vacant housing and violent crime. “Where you find sick and dying babies, you will find moms who are not doing well; you will find neighborhoods that are not doing well,” said Mark Chaffin, director of Research in Developmental and Behavioral Pediatrics at the University of Oklahoma Health Sciences Center. He has been an adviser to the Columbus task force. You also will find a legacy of racist policies, poverty and a lack of investment in the neighborhoods, said Jason Reece, the Kirwan Institute’s director of research. Infant mortality is “really one of the premier civil-rights issues that we still are dealing with in our country today,” he said. Ohio had the nation’s worst black infant-mortality rate on record in 2011 at 15.5 deaths per 1,000 births. In six of the eight hot spots in Columbus — everywhere but Franklinton and the Hilltop — people of color are the majority. “Racism has had an effect on the health of black people in America,” James said. A growing body of research suggests that chronic stress over the course of a family’s history triggers genetic changes that predispose people to problems, including preterm birth. “The persistence in this disparity, I think, represents some of the most-egregious remnants of slavery,” James said. Regardless of a neighborhood’s circumstances, “The parents don’t want anything different for their children. They want them to grow up and be successful,” said Dr. Edward Shepherd, chief of neonatology at Nationwide Children’s Hospital. “Oftentimes, these people have had very difficult choices their whole lives,” he said. “And kids don’t have any choice in who their parents are.” In general, poverty, crime and vacant housing join a handful of other measures that correspond to high rates of infant death. But the neighborhoods also have important differences, which makes a single approach to lowering deaths unlikely to work citywide. Franklinton, for example, is the poorest and the whitest. And the city’s northeast has the most foreign-born people, but a comparatively high number of residents with cars. The infant-mortality task force has issued recommendations to help babies survive here and has assigned the work to various people in the public and private sector. An executive team is shepherding those plans with an eye first on safe sleep habits, smoking cessation and prevention, and prematurity prevention through prenatal care and family planning. Of the 81 infant deaths in the first half of this year, 43 were because of complications from prematurity; 17 were attributed to congenital disorders. The third-most-common cause falls into a category called “sudden unexplained infant death” and is almost always linked to babies’ sleeping where they shouldn’t — on a couch, with a bunch of blankets and pillows, in bed with a parent. They should be alone, on their backs and in a crib, experts say.