State, researchers attack infant mortality

By SAODAT ASANOVA-TAYLOR
Capital News Service
LANSING – As infant mortality rates continue to rise across the state, the Department of Community Health is implementing a new plan that should reduce the number of deaths and disparities based on geography, socio-economic issues and race.
Last October, the Department of Community Health convened a summit to identify strategies to reduce and prevent infant deaths.
Based on recommendations from politicians, health specialists and community leaders, the department developed a plan to reduce the infant mortality rate.
Angela Minicuci, a public information officer for the department, said her agency continue to seek input as it works to update the current statewide plan. “We’re in the process of finalizing the updates to the plan which will continue to serve various populations across the entire state.”
According to Minicuci, the new plan will work to reduce unintended pregnancies by making family services available and implementing a system to ensure all women deliver at locations that best serve their specific needs. It also will improve efforts to prevent teen pregnancies.
Department of Community Health data shows that in 2008, the infant mortality rate was 7.4 percent per 1,000 live births., but in 2009 it rose to 7.5, and in 2010 continued to rise up to 7.7
The major cause of infant mortality is premature births, which are at a higher rate than the national average, according to the department.
Jane Zehnder-Merrell, a senior research associate at the Michigan League for Human Services, said a variety of factors contribute to the increase of premature or pre-term births.
The power of infant mortality rate reflects overall health problems in the state, and socio-economic factors play a big role, she said. “Lack of prenatal care, access to quality medical care, social disparity and unintended pregnancies are the most common problems that impact the ultimate delivery of the baby.
“Mothers who don’t have insurance or those with too high of an income are put in a stressful position,” she said. “They have to find a provider and make an appointment and the whole process can take months,” she said.
“We need a diverse task force with representatives from communities to start talking more about the issues that complicate pregnancies,” Zehnder-Merrell said. “The focus should be on the communities all across the state.”
Michigan also has high disparities in infant mortality rate based on race.
In 2009, the rate per 1,000 live births among Caucasians was 5.4, among African-Americans 15.5 and among others 6.6, according to the Department of Community Health.
Minicuci said taking these numbers under consideration, the department focused more on communities where there is a higher African-American infant mortality rate.
Russell Bush, the medical director of the Lapeer County Health Department, said infant mortality is a problem that should be looked at across the state.
“I understand the state’s focus on communities where the numbers of infant of mortality are high, but children are born and die in every county. Kids should have an equal chance at survival everywhere,” he said.
Community Health data show that Lapeer County has a higher mortality rate than the state average.
“Most of the deaths are related to pre-term births and difficulty to access medical services. We have limited public transportation and some people from rural areas don’t have cars,” said Bush.
Transportation is also a big problem in other parts of the state.
Kit Mikovitz, personal health administrator at the Grand Traverse County Health Department, said many areas in Northern Michigan don’t have facilities for delivery.
“We have people coming to us from Cheboygan, Alpena and other areas. It takes up to an hour. If the mother is at risk and far away, we can’t really help her until the ambulance arrives,” he said.
According to Mikovitz, funding cuts have limited services to prevent infant deaths, and the department should consider that factor in developing its plan.
“We would love them to look at infant mortality on the state level and come up with an effective work plan and education programs that can reduce infant mortality rates,” said Bush.
Meanwhile, researchers continue to study how to reduce the infant mortality rate, in particular pre-term births.
For example, a study by the National Institutes of Health and Wayne State University determined that performing a cervical ultrasound to identify pregnant women with a short cervix and then using vaginal progesterone treatments reduces premature births.
Sonia Hassan, associate dean for maternal, perinatal and child health care at the Wayne State University School of Medicine, said the study was based on clinical trials of vaginal progesterone worldwide.
“We are working closely with the Department of Community Health to implement this test in hospitals across the state,” she said.
According to Hassan, it is important that physicians and health care professionals counsel patients that there is a new test to identify whether they are at risk for premature births.
“This test can reduce the risk of premature births by 45 percent. We have seen positive results of this treatment and hope it will help to reduce the rate of infant mortality in our state,” she said.