A lofty goal: Local health officials continue to step up efforts to reduce infant mortality

Local officials are continuing to step up efforts to reduce the number of infants in Bartholomew County who die before their first birthday and have set what they describe as a “lofty goal” to reduce the county’s rate of infant deaths by about a quarter by the end of the decade.

From 2017 to 2021, a total of 35 infants who resided in Bartholomew County died before turning 1 year old, according to the figures provided by the Indiana Department of Health.

That comes out to an infant mortality rate of 6.8 deaths per 1,000 live births over those five years, which was right in line with Indiana’s rate but higher than the U.S. rate of about 5.5 over the same period, according to the Centers for Disease Control and Prevention.

Not all of these deaths may have occurred in the county, as state health officials record 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.

Records from the Bartholomew County Health Department, which tracks deaths that occur within the geographical boundaries of the county, show that there were 16 infant deaths in the county from 2020 to 2022.

That figure includes seven stillbirths, which is the death of a fetus at or after 20 weeks of pregnancy, according to the National Institutes of Health. Some organizations draw distinctions between stillbirths and infant deaths.

Two of the infant deaths were due to extreme prematurity, which indicates that they were born before 28 weeks of pregnancy based on definitions from American Congress of Obstetricians and Gynecologists. There also was one infant death caused by asphyxiation that was likely due to unsafe sleep practices.

One of the still births was due to opioid use disorder and cocaine use during pregnancy, while another was caused by complications from a COVID-19 infection.

All but three of the infant deaths occurred within three hours of birth. Only one infant who died during that period was older than 11 days.

The most recent figures from state health officials show a considerable decline in infant deaths in Bartholomew County over the past several years. By comparison, 57 infants who resided in the county died before turning 1 year old from 2011 to 2015, or a rate of 10.7 deaths per 1,000 live births.

In 2022, there was only one infant death in the county, according to the Bartholomew County Health Department.

‘Lofty goal’

Now, local officials are hoping to build on that momentum and reduce the county’s infant mortality rate to 5 deaths per 1,000 live births by 2030, which is in line with targets set by the CDC, said Patty Pigman, infant mortality prevention coordinator at Healthy Communities.

To meet that goal, the county’s infant mortality rate would need to drop about 26% compared to the aggregate rate from 2017 to 2021.

The infant mortality rate is the ratio of infant deaths per 1,000 live births. For the purposes of calculating the rate, an infant is defined as a baby less than 1 year of age. Researchers and policymakers often consider the infant mortality rate to be a barometer of the overall health of a community.

In 2020, 16 states were already meeting the federal target for 2030, according to the CDC. Indiana was not one of them.

The Hoosier State had an infant mortality rate of 6.75 in 2020, which was the ninth highest rate in the nation, CDC records show.

“It’s a pretty loft goal,” Pigman said. “The state is not at a five.”

New effort

As local health officials start to approach reaching the goal over the next few years, they have plans to launch initiative next month that focuses on reducing stillbirths.

The new initiative involves a free mobile application called “Count the Kicks” by Happy Birth Day Inc., which was founded by five Iowa moms who lost babies to stillbirth or infant death.

The app includes an algorithm that reminds patients to track fetal movement during late second trimester and third trimester, which can help alert them to red flags in their pregnancies.

The American College of Obstetricians and Gynecologists and other medical groups recommend that patients be aware of fetal movement. Research shows as many as 1 in 4 stillbirths may be preventable.

“They built this app a couple of years ago, and they’ve done some studies, and they’re actually seeing a decrease in the rate of stillbirths in Iowa,” Pigman said. “…We’re partnering with Healthy Birth Day Inc. to bring Count the Kicks to Indiana and to Bartholomew County. So we actually have a training in two weeks.”

Pigman said it was hard to say what other efforts may be launched to help reach the 2030 goal, as infant mortality is a complicated issue that can be difficult to address. In recent years, Health Communities has focused a significant part of its efforts on promoting safe sleep habits and helping address substance use disorder among pregnant women.

Local officials said they’re hopeful that they can reach the goal and recently celebrated that the local aggregate infant mortality rate fell below the state rate from 2016 to 2020 for “the first time in like a decade,” reaching 6.5.

It also was the lowest rate since at least the five year period from 1999 to 2003, state records show.

“There are a whole host of reasons why a baby might pass away before their first birthday,” Pigman said. “A lot of them … aren’t preventable, or the things that need to be done to prevent them are a lot bigger than something that we could just kind of pull a lever on here.”

“Being in a state that has had really problematic infant mortality for a long time, it’s really encouraging that we’re even getting this close (to the goal),” Pigman added.