Kansas Health Institute | Information For Policy Makers. Health for Kansans.

TOPEKA — Changing Kansas law so health officials could survey new moms could help the state better understand and reduce its high infant mortality rate, legislators were told Monday.

The Senate Public Health and Welfare Committee heard testimony on Senate Bill 448, which would allow the Kansas Department of Health and Environment to send follow-up surveys to new mothers. Under current law, health officials cannot use information collected on birth certificates to contact parents.

The surveys would include questions about prenatal care and other factors related to births and pregnancies.

"At present, the law does not allow follow-back on the birth certificate for public health surveillance and monitoring purposes," said Linda Kenney, director for family health at KDHE. "This puts Kansas at a disadvantage in having quality data for program and policy decisions."

The changes proposed in the bill would make the state eligible for federal funding to conduct the surveys as part of a program run by the Centers for Disease Control and Prevention. The Prenatal Risk Assessment Monitoring System, or PRAMS, could help the state learn more about the factors in each community that contribute to infant mortality and sick babies, Kenney said.

Thirty-seven states take part in the program. In addition to collecting local data about infant deaths, the system allows states to compare information, Kenney said.

The local information is most important because the factors contributing to infant mortality are complex and can vary widely even within a state, said Dr. Dennis Cooley, a Topeka pediatrician and chairman of the Kansas Blue Ribbon Panel on Infant Mortality.

"The causes are numerous, and we've known about most of them for a long time, but we're finding out that there are newer ones, such as mothers who have asthma or are obese," he said. "These are things we're starting to find out as we get more information. If we're going to be successful in bringing down our own infant mortality rates, we must know which of these things are occurring at the local level... Each community and local level has a different subset of this vast number of causes."

Christy Schunn, executive director of the SIDS Network of Kansas, said the ability to do follow-up interviews could help organizations better target education efforts about, for instance, appropriate sleeping environments for infants.

"Sixty-seven percent of infants we come into contact with have unsafe sleep environments," she said. "That has to change. We need to figure out more information about how parents are putting their children to sleep and how to change that. The abstraction process about what happened at the time of death and other information from families gives us a lot of information about what is going on."

Birth certificates in Kansas are among the most confidential in the nation after a legislator several decades ago campaigned to tighten access to the records, Kenney said.

When the state applied for PRAMS funding in 2006, KDHE's application was denied because of the state's strict no-follow-up law, Kenney said.

The CDC will start taking applications for the next funding cycle later this year, said Leslie Harrison, the PRAMS team leader for the agency.

The process is competitive but states, some cities and tribal organizations that keep vital records generally receive between $100,000 to $175,000 each year to complete the surveys and analyze the data, she said.

Kansas' infant mortality rate is 20 percent higher than the national average and higher than some developing countries, such as Cuba. Changing the law to allow the state to conduct surveillance on new mothers and risk factors from their pregnancies was one of the blue ribbon panel's top recommendations.

The committee is expected to resume discussions on the bill later this week.