Local health officials are “pleased” but say more work still needs to be done after seeing a decrease in the number of infant deaths within Bartholomew County so far this year.
From Jan. 1 to Oct. 13, two infants died within the Bartholomew County limits, according to the Bartholomew County Health Department. By comparison, eight infants died within the county during all of last year.
A total of 54 infant deaths have been recorded within Bartholomew County since 2009, including nine in 2011, according to county records.
The cause of death in both cases this year was listed as “extreme prematurity,” according to county records. Both infants were less than 3 months old and were Bartholomew County residents.
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Officials at Columbus Regional Health and Healthy Communities said they have amplified outreach and education efforts in recent years to curb the county’s alarmingly high infant mortality rate, but it is too soon to know the extent to which these efforts may have contributed to the lower numbers this year.
Infant mortality, which refers to the death of a baby younger than 1 year of age, is a complex issue, and experts say it can be difficult to pin down the causes and contributing factors that ultimately lead to the death of an infant.
Researchers and policymakers often consider the infant mortality rate to be a barometer of the overall health of a community.
“There is a decrease in numbers,” said Chris Newkirk, a clinical quality advisor at Columbus Regional Hospital and member of the Infant Mortality Prevention Action Team and Healthy Communities. “I would say 2019 was a really high, abnormal number for us that we did not want to see — 2020 looks more in line with where we would expect to be based on our population.”
“We’re really pleased with the improvement that we’re seeing thus far,” she said.
However, those figures only offer a partial picture of infant mortality in Bartholomew County.
The Bartholomew County Health Department tracks deaths that occurred within the county and statistics may not reflect the infants’ county of residence.
In other words, the department’s figures would not include infants who resided in Bartholomew County but died at hospitals in Indianapolis or elsewhere.
“Those babies that we transfer north that may end up dying then in Marion County, there is a bit of a lag time in that reporting,” Newkirk said. “So, I do feel like that number will be higher than two just based on information that we’re already aware of for this year.”
The Indiana State Department of Health Data from the Indiana State Department of Health shows that 168 infants who resided in Bartholomew County died before turning 1 year old between 1999 and 2018.
ISDH records infant deaths by the county in which the infant resided at the time of death, which is not necessarily the county in which the infant died, state health officials said.
ISDH spokeswoman Megan Wade-Taxter said she expects 2019 county-level infant death statistics to be released “in the next several weeks.”
The causes of infant deaths within Bartholomew County last year included issues related to premature birth or preterm labor, one case of methadone intoxication and rulings of a sudden unexpected infant death (SUID), among others, according to county records. A baby is considered premature if born prior to the 37th week of gestation.
Additionally, the number of deaths attributed to unsafe sleep environments last year increased to three, compared to one in 2018, Healthy Communities officials said in a previous interview.
There have been no reports of deaths due to unsafe sleep environments so far this year, county records show.
Patty Pigman, co-coordinator of the Infant Mortality Prevention Action Team at Healthy Communities, said she and her team are seeing a trend of fewer deaths related to unsafe sleep environments, but cautioned that, “We won’t know until early next what the total number is and what all the causes will be.”
While not all causes of infant death are preventable, Indiana as a whole tends to fare poorly in many measures of public health and social determinants considered risk factors for infant mortality, including smoking during pregnancy, obesity, diabetes, child poverty, lack of prenatal care, among others.
However, Indiana’s infant mortality rate has declined for three consecutive years, according to the Indiana State Department of Health.
On Oct. 1, Indiana Gov. Eric Holcomb announced that the state’s infant mortality rate in 2019 fell to the lowest level since the state began recording those deaths 120 years ago.
Preliminary data released by ISDH shows the statewide infant mortality rate fell from 6.8 per 1,000 live births in 2018 to 6.5 in 2019. The mortality rate among Black infants fell from 13 to 11 in 2019.
Currently, it is unclear how Indiana ranked nationwide in 2019 as the Centers for Disease Control and Prevention has not yet released comprehensive data for all 50 states.
In 2018, the infant mortality rate in Indiana was 6.8 — tied for 11th highest in the country, according to the CDC. In 2017, the infant mortality rate in Indiana was 7.3, seventh highest in the country.
By comparison, New Hampshire had the lowest infant mortality rate in the country in 2018, with 3.6, while Mississippi had the highest, with 8.3.
The U.S. rate in 2018 was 5.7, unchanged from 2017 and down slightly from 5.8 in 2016, according to the CDC.
However, there are striking disparities in infant mortality by race and ethnicity.
Black infants were twice as likely to die before their first birthday as white infants in 2018, according to the CDC. The 2018 rate for white infants was 4.6, but the rate for Black infants was 10.8.
“The best way to reach Gov. Holcomb’s goal of having the lowest infant mortality rate in the Midwest is to focus our efforts on the communities that are disproportionately impacted and ensure that women have the tools they need to achieve a healthy pregnancy,” said Dr. Kristina Box, the state’s health commissioner, in a statement to media.
Local efforts
Last year, officials at Healthy Communities set out priority areas to address infant mortality, including promoting safe sleep environments, preconception care and decreasing premature births.
This year, they had planned to continue focusing on the same priority areas and expand tobacco cessation efforts, educational outreach and other programs, but had to shift gears after the COVID-19 pandemic sidelined much of their in-person outreach and education efforts, Pigman said.
Now, a significant portion of the team’s efforts and programs have migrated online via social media or video chat platforms such as Zoom, though they are still engaging mothers “early and often” at CRH’s birthing center, said Amanda Virostko, co-coordinator of the Infant Mortality Prevention Action Team.
The Infant Mortality Prevention Action Team also has continued to provide educational information and supplies to mothers and expectant mothers, including breast pumps and other supplies mothers have said they need, Virostko said.
The team is currently in the process of venturing into the world of podcasts to expand their reach, Pigman said.
”A lot of the topics that we were wanting to discuss with our providers and our patients and our clients were bigger than a two-minute public-service announcement,” Pigman said.
“We’re just willing to try anything to get to people,” Pigman added.
Formed last year, the Infant Mortality Prevention Action Team that includes more than 50 members from community organizations, including police and fire departments, local physicians, nurses, social workers, higher education, social service agencies, among others, officials said in a previous interview.
In 2018, CRH started a Fetal Infant Mortality Review Team, which reviews every case of infant death in Bartholomew County. The local review team was one of the first such teams in Indiana.
“We’ve got a lot of work yet to do, but we’re pleased with what the numbers look like so far,” Pigman said.
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To learn more about prevention strategies for infant mortality, visit https://www.crh.org/community-foundation/healthy-communities/infant-mortality-prevention-team.
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