Elm City combats infant mortality

From 2003–2009, 12 out of every 1000 babies born in New Haven died, and a higher percengtage of those deaths were African American children, according to the Community Health Index recently published by DataHaven.

The Index also reported that three times as many African American mothers as white mothers are experiencing infant mortality. This, however, is not unique to New Haven, but is rather a nationwide trend, according to executive director of DataHaven Mark Abraham, and epidemiologist and Yale School of Public Health lecturer Dr. Amanda Durante, who worked with Abraham to publish the maternal health section of the report. Many researchers in New Haven, at Yale and nationwide are working to solve the mystery behind this disparity. An established cause of many infant deaths is premature birth and low birth weight, which seems to be more common to black women.

African American babies tend to be born smaller not due to poor care of the mother or the baby, Durante has found, adding that the reason remains unclear.
Durante’s research also involved analysis of low birth weight in African American women, focusing specifically on modifiable risk factors, such as smoking and non-modifiable risk factors, like a chronic disease.

Their major findings were that pre-existing chronic conditions in the mother such as chronic hypertension or diabetes, as well as smoking during pregnancy, increased the risk of low birth weight.

“Smoking seems a modifiable factor,” she said. “But what is it about these chronic health conditions that might predispose women? Are these conditions not being managed well? We don’t know.”

Dr. Megan Smith, a Yale Medical School psychiatry professor and the director of the New Haven Mental health Outreach for MotherS (MOMS) Partnership, believes that stress affects pregnancy. Her program, MOMS, works to promote the mental health of mothers in New Haven. They published a survey of mothers across the city that found that mothers felt they needed more support to prevent and control stress.

Stress, she said, would perhaps help to explain the source of higher infant mortality rates amongst African American women. A study reported that black women experience higher level of stress than white women or Hispanic women, Smith said.

Previously, many believed that the higher death rates of African American infants were due to socioeconomic factors, but new studies seem to indicate that even African American women of the highest socioeconomic bracket are at increased risk for low birth weight, which indicates that race specifically plays a powerful role, said Maria Damiami, the director of women’s health at the New Haven Health Department.

But it is still unclear why African American women are at a greater risk.

“It’s not acceptable that there’s such a big difference, but we just don’t really know how to fix it,” Durante said. “We’re continuing to work on it.”

Despite the frustration of trying to solve what seems to be a medical mystery, New Haven has made progress in terms of infant mortality rates. In the 1980s, one out of every 59 babies born to a New Haven resident perished, according to a 1988 article in the New York Times. The article said that this was 70 percent higher than the national average, and higher even than many underdeveloped countries. Since the 1990s, programs like MOMS and New Haven Healthy Start have been working in New Haven to combat this problem and the infant mortality rate now matches the rest of the nation.

Damiami believes that the implementation of the Affordable Care Act, or “Obamacare,” will make a huge positive impact. She said the expansion of Medicaid in Connecticut will insure more women and provide them with increased general healthcare which will lead to healthier pregnancies.

Martha’s Place, a shelter for single women and families, also works directly with pregnant women. The shelter has a voluntary service that works to set women up with healthcare providers and provide a means of getting to their appointments, as well as a general support net for their pregnancy.

“They might not be leaving our shelters with a multi-million dollar home, but they will have a space of their own and they will be educated on what they can do, where they can go, what they’re entitled to, and what their rights are,” Yaritza Roman, a case manager for Healthy Start and Martha’s Place said.

The city faces a general lack of housing and employment opportunities for homeless women, in addition to a dearth of mental health resources, she said.
Despite the improved numbers, the deaths of infants are very real losses.

“Each infant death marks a huge loss to someone,” Abraham said.

According to the Community Health Index, one out of every 10 babies born inside of New Haven has a low birth weight.

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