Black infant mortality raises alarm

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Black babies are dying in Omaha.

That's the simple, straightforward message the group of about 40 people — most of them black women — had to work with. Their assignment was to take 10 minutes to come up with a way of spreading that message to the people who need to hear it.

The fact that the infant mortality rate is high among blacks in Omaha was no surprise to many of those at a community forum earlier this week at the Turning Point campus in north Omaha. That for every 1,000 black babies born in Douglas County, more than 14 will die in their first 12 months.

Or that the rate is three times higher than the county's white infant mortality rate: 4.7 deaths per 1,000 babies.

But a Douglas County Health Department map showing that the highest concentration of baby deaths was near 33rd and Lake Streets, in the area around Salem Baptist Church, surprised Thelma Sims, director of the Salem Children's Center.

Sims first saw the map about a month and a half ago.

"I was really devastated and sad," she said.

She lives and works in the area but hadn't known that from 2005 through 2009 the neighborhood's infant mortality rate was 27 to 33 deaths per 1,000 births — in the range of the rates seen in Indonesia, Zimbabwe and Kyrgyzstan.

Rates are harder to grasp than actual numbers, so when looking at the state's vital statistics for 2005-2010, for example, you find that 113 black infants died in Douglas County during that period.

Of those, the leading causes of death were listed as sudden infant death syndrome, 21; maternal complications of pregnancy, 20; prematurity, 16; and birth defect, 14.

Sims is one of three well-connected local black women who have been trained as community health advocates as part of the Connections Project, which is overseen by the University of Nebraska Medical Center. Sims, Kathy Trotter and Gail Ross are charged with getting the word out about high infant mortality rates, preterm births and low birth-weight babies; helping to find solutions to the problems; and, in general, being role models to young moms. They also will serve as moderators for three more community forums over the next several months.

The idea is that the approach to the problem would come not from some institution but from the community, said Jack Turman, a UNMC professor. Turman received a $172,000 grant from the State of Nebraska to administer the project, which also includes a peer-support program for first-time pregnant black women.

"It helps a community take ownership of the problem and the solution," he said.

Turman had developed and implemented a similar program in California before coming here.

It's not as if the local medical community has been on the sidelines in the effort to improve birth outcomes. Omaha Healthy Start, a federally funded initiative of the Charles Drew Health Center, and the Douglas County Health Department, with its Baby Blossoms Collaborative, are among the entities that continue to work on the issue.

But Dr. Joann Schaefer, the state's chief medical officer, said she backed the grant because she had been "looking for a project that was innovative and used out-of-the-box thinking in the way that we approach the problem."

One of the things that officials have heard "loud and clear" from the community, she said, was: "We need to be able to do some of this ourselves."

Ross, who is Turning Point's community relations director, said the project will help reduce SIDS deaths and the other main causes of baby deaths "by making sure the community in which these babies are dying is not only educated and made aware but also empowered to educate ... their family, their neighbors."

For example, Ross said, people need to know that babies should sleep in a crib by themselves, on their backs, without toys and blankets around them.

High infant mortality rates aren't unique to Douglas County. According to a new national report that uses 2007 figures (the most recent available), the rate for non-Hispanic black women in the United States was 2.4 times the rate of non-Hispanic white women.

The report, published by the National Center for Health Statistics, found that the difference in the rates was primarily because of higher levels of preterm births and preterm-related causes of death among blacks. Nearly one in five infants of black women was born preterm, the report said.

The author of the report, Marian MacDorman, said the study did not screen for socioeconomic status.

"What's interesting is that college-educated, non-Hispanic black women have higher infant mortality rates than white women that have not completed high school," she said.

Turman said the birth and mortality disparities exist across all socioeconomic levels. "It's a misnomer to think that it's totally explained by poverty or prenatal care or maternal education. And it's definitely not genetics — birth outcomes of black women from Africa or from the Caribbean (who give birth in the U.S.) are more like white women in America. So it's something about being African-American. Being here over generations."

Some researchers speculate that the stresses black American women face — "Life stress. Racial stress. Gender stress. Neighborhood stress. Unemployment stress" — contribute to the problem, Turman said.

"We know that prenatal stress impacts the development of the baby's brain," he said.

Part of the peer-support program, which will involve 20 pregnant women and 20 "peer supporters," will be to assess pregnant women's depression and anxiety levels and provide them with information about personal health and wellness, maintaining a healthy pregnancy, stress and the resources available to pregnant women.

"We're looking at the overall mental health and health of African-American women to see how that affects the birth outcomes," Ross said.

The peer supporters could help the first-time moms "deal with the stressors," she said, and keep them from resorting to stress relievers such as cigarettes, alcohol or drugs, all of which can harm babies' development.

Future forums will address individual and family skills needed for a healthy pregnancy; the role of fathers in supporting a healthy pregnancy; and dealing with depression before, during and after pregnancy.

At the end of this week's forum, all three groups had come up with suggestions for fliers that would be posted in day cares, child care centers, churches and even bathroom stalls. Five volunteers were given 60 days to decide what should be on the fliers and get them out. Similar projects will be assigned during the three future forums.

Trotter, a retired principal, said it's a small step toward solving a serious problem. "This is what the community is saying we need to do."

Contact the writer:

402-444-1109, bob.glissmann@owh.com

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