WICHITA — The Rev. Pamaline King-Burns works with the local health department here and also is a pastor in a neighborhood that has among the state’s highest incidence of black infant deaths.

At a recent meeting for the Wichita Ministerial Alliance, a gathering of 25 or so church leaders, King-Burns said she asked this question:

"How many pastors in this room have performed a funeral for an infant less than a year old?"

There were about 25 people in the room and, “every single one of them raised their hand,” King-Burns recalled. “You should have seen the look on their faces when they realized: we all have. Then I saw one of the pastors lean over to another and say 'Man, I've done more than one' with a really sad voice. I think that drove home the fact that these were churches represented throughout this city and it put a face to those numbers. It was really impacting," she said.

Emotional impact

Five of Kansas’ 1,121 zip codes accounted for a third of the black infant deaths between 1998 and 2007 — 66101, 66102, 66104, 66605 and 67214 (PDF). That last zip code is near King-Burns’ neighborhood in northeast Wichita.

The life-long Sedgwick County resident is a pastor at World Refuge Ministries, Inc., and a leader in the local health department’s Community Health Navigators (PDF).

The Navigators are a group of community volunteers — black, white, Asian, Hispanic — who help expectant mothers find affordable health care, programs such as Healthy Babies, and disseminate other health information.

King-Burns said she felt “very positive” about the community-based programs underway in Wichita, but that much work remained to be done.

“Some of the kids are paying attention and some aren’t,” she said. “I had one lady come up to me and said ‘You know, after your sermon I decided I'm not going to abort my baby.’ And I was really happy about that, but one day I was talking to her and she had a pack of cigarettes in her purse."

"Part of it is that they’re not getting prenatal care,” King-Burns said. But part of it is that they’re “not taking seriously the impact of some of their bad habits on the unborn child. Despite the fact that there are health warnings, studies show women continue to smoke, drink, use drugs. And I don't want to rule out chronic stress because they are under a lot of stress — joblessness and things like that.”

King-Burns said it’s hard to underestimate the emotional impact of babies dying in a community.

"Just think about the grief, the stigma attached to the loss of a child,” she said. “Is there a support system for her, access to counseling? And the expense — OK, you lost your baby, here's your bill. Now go find a job, or daddy's not here, or maybe he is there and he’s part of the problem."

Better communication needed

She said Wichita already has in place many of the programs needed to cope with the effects of infant mortality but that more communication among them was needed.

"We need cross-agency support. All of us need to come together and surround the person, or else it repeats itself,” she said. “Pastors, caregivers, doctors, SRS, Healthy Babies — all of us need to surround the mother who's lost a child. I don't think we're all connected like that yet.”

According to the latest statistics (PDF), Kansas has the highest rate of black infant mortality of any state in the nation: 19.6 of every 1,000 black babies born in the state in 2007 died before age one. In that year, 2,937 black babies were born in Kansas, 57 died.

"There's some data, or at least thought, coming out that the reason black infant mortality rates are high is due to the stress that mothers experience of being black in our society. Just constant stress,” said Dr. Dennis Cooley, chairman of the Kansas Blue Ribbon Panel on Infant Mortality. “When you're exposed to stress it has physiological factors that effect your pregnancy."

Cooley said technological changes in society and medicine have increased the survival rate of babies.

Between 1900 and 1940, overall mortality rates in the United States fell 40 percent and child mortality was cut in half thanks to basic water filtration and chlorination.

Then in the 1970s, Cooley said, advances in caring for premature births accelerated. Babies that just a few years before would have died were suddenly more often saved.

"We saved a lot of babies that were very, very premature," Cooley said. Now, he said, those advances are bringing into sharper relief the differences in black and white infant mortality rates.

Related stories:

→ Kansas has one of the highest infant mortality rates in the U.S.

→ Road map sets goals for reducing state's alarming infant mortality rate

→ National spokesperson on infant mortality to tour Kansas

Crisis in the Crib: Saving Our Nation's Babies from Kansas Health Institute on Vimeo.

Infant Mortality for the African-American community is a pressing, but often overlooked, health disparity. The rate of death for black babies before their first birthday is twice the rate of white babies and greatly outpaces the national average. For some communities these deaths can seem like a normal part of life, but they are strong indicators of the health of the community. Produced by the Office of Minority Health, U.S. Dept. of Health and Human Services