Officials alarmed by rise in black infant deaths

Public health officials at both the local and state level are fretting over new statistics that show wide discrepancies in infant mortality rates between white and black Bostonians.

"It's been a concern of ours for a long time," said Maia BrodyField, chief of staff to the Boston Public Health Commission. "Specifically for infant deaths, it's that it really does serve as an indicator of a population as a whole."

A commission analysis of 2006 birth trends, recently released by the state Department of Public Health and the most recent data available, showed that black infants accounted for 29 percent of Boston births, but 65 percent of all infant deaths.

Latinos saw 2.9 deaths per 1,000 births, contrasted with 13.2 deaths per 1,000 live births for blacks.

City-wide, the infant mortality rate has been steadily decreasing to 5.8 deaths per 1,000 live deaths from 8.4 deaths in 1997.

Statewide, there were 368 infant deaths, defined as deaths of infants less than one-year-old, down from 391 infant deaths in 2005.

No simple answer exists as to why there's such a gap, health officials say, due to the complicated nature of pregnancies.

"There's not a single answer that would explain why black infants die two-and-a-half times more than their white counterparts," said Lauren Smith, medical director for the state Department of Public Health.

Officials say they have to look at a woman's health before the pregnancy, and track any nutrition issues, tobacco use and diabetes.

The health disparities remain a "key priority" for the department, Smith said. "Infant mortality is a pretty glaring one," she added.

City Councillor Chuck Turner said he still had to read through the report.

"I think the fact that they're taking action and it's dropping is good," he said. But why it's going down for some and not others is something that needs to be looked at, he added.

The commission is planning a more detailed analysis due out in a few weeks, to get at the causes and figure out the areas of services that may not be connecting with women before pregnancy. With a budget of almost $6 million for birth disparities, the commission serves 3,000 families every year through services for pregnant and parenting minority women.

The department is using a pregnancy risk assessment monitoring system to gather data throughout the system and connecting with local task forces in Boston, Worcester and Springfield to reduce the infant mortality rates, according to Smith.

"It's really about support services," said Bill Walczak, head of the Codman Square Health Center, pointing to homelessness and substance abuse services as examples. "They need to be addressed in order to ensure a healthy delivery of the baby."

He added: "A woman who is pregnant needs to focus on a full package of health issues, not just the medical visit."

In Codman Square, the infant mortality rate was so high twenty years ago the Boston Globe was prompted to write a series, titled "Births in the Death Zone."

"While it's certainly far from being a great situation, it's a much better situation than it had been," Walczack said.

Meanwhile, local community health centers are stepping up to the plate.

"We still have a rate that's double the rate of Boston," said Tarma Johnson, director of clinical health services at Mattapan Community Health Center and a nurse practitioner.

At the Blue Hill Ave. health center, Johnson says that a caseworker sees patients and follows them for two years.

Officials are also focusing on Vitamin D deficiencies. Vitamin D, sometimes manufactured through sunlight penetrating the skin or through the liver, maintains normal levels of calcium and phosphorous, according to the National Institutes of Health.

Through testing that started last year, they found that many of their patients have low amounts of Vitamin D, and that 60 percent of black babies that die were born to women who are Vitamin D deficient.

It's going to take a while for them to see the full link, according to Johnson, but until then they are offering 2,000 units of Vitamin D a day.

"We have mostly been successful in dealing with the access to care issue," Walczack said. "But that doesn't mean the problem's over."