From Crib To Cradle: Infant Death Disparities

From Crib to Cradle: Infant death disparities

The first time I laid eyes upon my beautiful new granddaughter, she lay peaceful in her cradle. She had beautiful black curly hair. Her eyelashes were so long I thought they were butterfly wings. Her ebony skin was in full contrast with the white dress she was wearing. She looked like an angel.

It's never easy to hear word that a child has died; unfortunately all too often in this country, a child dies before it reaches the age of one. Infant mortality is defined as the death of a child in his or her first year of life. (Infant mortality) Javae was six weeks old on that day we buried her in the cold earth on a wet and snowy day in early March. The cradle was her "burial cradle," a term I had never heard before. The little angel that I had just met was now truly an angel.

In a recent report dated March 10, 2006 CNN reported that approximately 2 million babies die within the first 12 months of their life worldwide. This report goes on to say that the United States has the second worse mortality rate of infants in the developed world. (Green) Infant death rates in the United States are higher than that of Japan, Sweden, and the United Kingdom. This fact is unacceptable. In this day and age of modern medicine our children are dying at an alarming rate.

According to studies, infant mortality rates (IMR) on are the decline. In the past 45 years the death rate of American infants has declined from approximately 20 deaths per 1,000 live births to 6.9 deaths per 1,000 live births. The decrease however, is mostly among Caucasian infants; the fact is that ethnic groups are still on the increase. African-American babies are twice as likely to die before their first birthdays as Caucasian babies. To date there has been an improvement in the Infant Mortality Rate among blacks in America. In a statement made by U.S. Surgeon General David Satchel, PhD, MD, the African-American population died at a rate of 40.5 percent more than their Caucasian counterparts in 2002. (Limtanakool, 2005, pp. 6-6 2/5)

An article in Health Affairs discusses the disparities between Caucasian and black infants over the last several decades:

The African American infant mortality rate has dropped by two-thirds over four decades, from 44.3 per 1000 in 1960 to 14.1 per 1,000 in 2000, in parallel with a drop in the overall U.S. infant mortality rate from 26.0 to 6.9. However, the black-white infant mortality gap as measured by SMR actually worsened from 1960 (1.970 for male and 2.073 for female infants) to 2000 (2.519 for male and 2.515 for female infants). (Satcher & Fryer, Jr., 2005, p. 459)

Such disparities among the races may be contributed to many reasons: lack of pre-natal care, the mother's age, and the socioeconomic factors among America poorest of families. The fact is that the lack of prenatal care is putting our infants at risk. Education is the key to ensuring that pregnant mothers receive proper prenatal care. In a recent study conducted by the health departments of Gladsden and Hillsborough Counties in Florida; when asked "Why do you think black babies die in your community?" the top three answers by young mothers were as follows: poor nutrition, lack of adequate healthcare, and a lack of education. (Close)

Women who are pregnant and not receiving proper prenatal care are more likely to be poor, unemployed, unmarried and lacking in a high school education. Other factors in mothers receiving little or no prenatal care, or perhaps starting the prenatal care in the third trimester may include the mother's own sense of self worth, the acceptance of a new child, lack of support from family members or their partners. (Unknown, Sept/Oct 2005) Studies show that mothers who are married tend to start their prenatal care earlier than mothers who are unwed. It also shows that young mothers are among those who tend to delay any type of prenatal care, as are those who are unemployed. Mothers who are employed during their first trimester tend to seek physician care earlier than those who are unemployed due to the fact that they are in a more stable financial income and more likely to have health insurance coverage. Among many unemployed mothers obtaining the financial means to see a doctor is impossible. Although most all states offer some current form of coverage for expectant mothers, there seems to be a lack of urgency on the mother's part to receive assistance for their care. (Pagnini & Reichman, Mar/Apr 2000) Pagnini and Reichman state that the "proportion of pregnant women receiving care in the first trimester--83% overall, and 72-74% among black and Hispanic women--falls short of the Healthy People goal of 90%." (2000)

Socioeconomic factors are just a few reasons that there are disparities among the races with regard IMR. Cultural attitudes regarding pregnancy and raising children may also contribute to such disparities. IMR among black babies may never fully be proven or explained, but it is important to look at the aforementioned contributing factors, as well as, consider racism. There is no real understood reasoning behind the high IMR in African-American babies, but the greatest suspect is the inadequate welfare in these United States. It is time for reform on a national level of our health care system.

There are many organizations dedicated to the education and studies of healthy babies, among them are the March of Dimes. The March of Dimes tirelessly devotes itself to preventing birth defect and genetics studies. This organization states that 12% of all births in the United States are premature birth and the proper prenatal care may help to reduce that number. The March of Dimes Foundation reports that the most common factor of infant death among children less than 2 months old is caused by birth defects. Approximately 25% of neonatal deaths can be contributed to some form of birth defect. Premature birth also are a leading cause, 11% of infant death is due to premature birth. (Neonatal Death, 2006) So, what about the other 64% of deaths among our infants?

In 2006, approximately 2,500 babies will die this year from unknown causes. (Peterzell, 2005) The medical term for this is Sudden Infant Death Syndrome (SIDS). SIDS is defined as the sudden death of an infant under the age of one, whose death remains unexplained even after a thorough investigation, including autopsies, investigation of the death scene and review of clinical history. The victims of SIDS appear to be healthy viable infants prior to death. SIDS cannot be predicted nor can it be prevented, even by a physician. There is no suffering when death occurs, it is usually very rapid