Infant Mortality: A Call to Action for MCH Programs
By Mike R. Fraser, PhD
As an indicator of our overall maternal and child health status the United States’ infant mortality rate is a reminder of just how much work we’ve done to improve the health of women and children and just how far we have to go to truly realize our vision of healthy children, healthy families, living in healthy communities. Our nation’s infant mortality rate is high among developed countries – we rank 28th in the world according to the Centers for Disease Control and Prevention (CDC) – and this is something about which we all should be very concerned. State and territorial Maternal and Child Health (MCH) programs are the natural home for infant mortality reduction programs, and many play a leading role in infant mortality reduction in states and territories. But what does this really mean for women and children?
State leadership means supporting programs that promote a number of interventions to assure women are healthy before, during and after pregnancy. It means educating women and families about the things we do that affect birth outcomes such as poor eating, lack of adequate prenatal care, smoking and substance abuse while pregnant, and other behavioral factors. Certainly there is a lot we can do to improve birth outcomes by focusing on healthy living and the lifestyle choices that women make. And many of the programs run by Title V MCH agencies do exactly that and with great success.
But one area in which we have a lot more to do involves more than just the “patient.” Instead, it involves the other side of maternal and child health: the community and the environment in which families live. We know that women who live in poverty, without access to community resources and supports, face stressful living conditions and experience unsafe communities are likely to disproportionately experience poor birth outcomes including infant death. According to the CDC, the infant mortality rate for African American women is twice (14.1 per 1000) than of white women (6.9 per 1000). The experience of racism, the experience of stress, the experience of living in poverty disproportionately impact African Americans and lead to infant mortality rates higher than that of whites. Are our MCH programs taking these factors into account – are we truly “Making Change Happen” in this critical area of maternal and child health? What does it mean to address racism as part of a program to reduce infant mortality? What does it mean to take on economic security for women as part of our statewide efforts to save babies and improve the health of women, children and families in our communities?
Infant Mortality Awareness month is a call to action for MCH organizations committed to addressing the individual and social causes for infant death in the United States. Let’s use this month to remember all the great work we have done to improve the health of women and children, but also to move us forward in developing new and innovative strategies to reduce infant mortality and other health disparities. That will mean incorporating both individual and community level interventions to address the root causes of poor birth outcomes. By addressing these root causes we will not only be addressing infant mortality, but myriad other conditions associated with poverty, lack of opportunity, and ultimately racism itself. If MCH programs do not take a leadership role in this work who will? With over 75 years of experience under our belt the time is now to move our country to being at the top of our sister nations, not the bottom, when it comes to infant mortality. I look forward to learning more about how you are addressing this important issue and sharing what you are doing with your peers and partners nationwide.