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Forsyth infant deaths fall a bit
Statewide, mortality rate increases slightly to 8.5 for every 1,000 live births
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Published: September 5, 2008
Updated: 09/05/2008 01:55 am
A slight decline in Forsyth County's infant-mortality rate last year was welcome news to local health-care officials yesterday.
But they stressed that until more women of childbearing age -- of all races -- are in better mental and physical health before conception, the rate is not likely to decline significantly anytime soon.
Forsyth's rate was 11.1 deaths for every 1,000 live births, according to statistics released by the N.C. Division of Health and Human Services. The rate was 11.4 deaths in 2006 and 8.9 deaths in 2005.
For Region II of the state, a 20-county area that includes all of the Triad and Northwest North Carolina, there were 9.2 deaths for every 1,000 live births. The rate was 9.1 in 2006.
"The reason there was not much change in the rate is that the main problems affecting infant mortality still remain largely unaddressed," said Tim Monroe, the health director for Forsyth. "No specific constellation of prenatal or post-birth services will fix this.
"There's no question that prenatal care is important," Monroe said. "But the preconception health of women in their reproductive years is being recognized more as a critical component for reducing infant deaths."
The state's rate increased slightly to 8.5 deaths, up from 8.1 in 2006, which was the lowest rate in state history. The division reported that the state had the highest recorded number of live births at 130,886.
"Many women of childbearing age in North Carolina are entering pregnancy with risk factors that affect their health, as well as the health of their baby," said Leah Devlin, the state's health director.
"One-fourth of North Carolina women in this age group are obese," Devlin said. "Almost half don't get the physical activity they need, and another one-fourth use tobacco. Some women are also affected by high blood pressure, diabetes, mental-health issues or misuse of alcohol or drugs."
Despite the slight decrease in the 2007 rate, the local five-year average of infant deaths -- a number health officials give more credence to because it could signal an upward trend -- rose from 9.4 deaths to 9.8. In the past 10 years, Forsyth's rate has varied from a high of 14.7 deaths in 1997 to a low of 7.3 in 2003.
Forsyth's rate remains higher than other urban counties across the state. Durham, Guilford, Mecklenburg and Wake counties all had lower infant-mortality rates last year. They ranged from 6.5 deaths in Mecklenburg (up from 6.2 in 2006) to 9.5 deaths in Guilford (down from 10.6).
There were 5,134 live births in Forsyth in 2007 -- an increase of 138 over 2006. There were 3,672 live births of white infants and 1,462 of nonwhite infants, the agency reported.
There were 57 infant deaths in the county last year, the same as 2006. There were 29 deaths involving white infants, or an infant mortality rate of 7.9. There were 28 deaths involving minority infants, or a 19.2 mortality rate.
For the state, the white infant-mortality rate was 6.3 compared with 6.0 in 2006, while it was 13.9 for nonwhite infants, up from a record low of 13.6 in 2006.
According to the Forsyth County Health Department, a black infant born in Forsyth is nearly three times more likely to die before reaching his or her first birthday than a white infant.
"African-American women in North Carolina are disproportionately affected by poor health, lack of health insurance and high rates of poverty," Devlin said.
The division reported that prematurity and low birth weight accounted for 18.6 percent of deaths of infants under 1 year old, and for 27.3 percent of the deaths of infants under 28 days old.
Birth defects were the cause of 18.2 percent of the deaths, and sudden infant death syndrome, or SIDS, accounted for 8.9 percent. Homicide or assault was blamed for 1.1 percent of the deaths.
"About 75 percent of infant deaths are connected to premature birth," said Dr. Robert Dillard, a professor of pediatrics at Wake Forest University School of Medicine and the medical director for the neonatal intensive care unit at Forsyth Medical Center.
"Premature births are going to be hard to reduce until you can reduce the stress in these women's lives, especially those living in low-income households or in poverty," Dillard said.
North Carolina has one of the nation's higher infant mortality rates. Based on provisional 2004 and 2005 data, the federal Centers for Disease Control and Prevention ranked the state 44th in infant mortality.
"In that sense, I believe we're going backward, not forward, in our efforts in this state and in this country," Dillard said.
■ Richard Craver can be reached at 727-7376 or at rcraver@wsjournal.com.
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