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Aug. 10, 2012
KANSAS CITY, Kan. For health officials, the death of a baby is more than just a loss for the parents.
The ripple effect could drive mental health needs for grieving households.
The death also could highlight a lack of education among new moms about safe sleep practices for infants.
Or it could signal a gap in a community’s prenatal services. And that, in turn, could mean expensive treatment in neonatal intensive care units and costly education supports later if those babies are developmentally disabled.
“It’s important to find out why we lose our babies,” said Terrie Garrison, program manager for the family planning/prenatal clinic in the Wyandotte County Public Health Department.
Wyandotte County may get that opportunity, and the first step could come later this month.
That’s when the United Methodist Health Ministry Fund and the Kansas Health Foundation expect to solicit proposals as part of their five-year, $900,000 initiative to fund intensive local studies into the causes of infant deaths. The studies are called fetal and infant mortality reviews.
The foundations announced their plan at a May meeting of the Kansas Blue Ribbon Panel on Infant Mortality.
They expect to make their funding decisions by the end of November, according to panel member Shannon Cotsoradis, chief executive of Kansas Action for Children. She said the foundations expect to choose up to three recipients from five counties targeted for their high infant mortality rates: Wyandotte, Geary, Saline, Shawnee and Reno.
According to the latest data available from the Kansas Department of Health and Environment, Wyandotte lost 8.5 babies for every 1,000 live births in 2010. The statewide rate of 6.3 per 1,000 live births was the lowest since record keeping began in 1912.
But that improvement came on the heels of the state’s recent history of lagging behind the rest of the country. Kansas was ranked 40th among all states in 2009, according to the blue ribbon panel.
The Governor’s Office established the task force three years ago, and among its recommendations issued in February 2011 was a call to establish fetal and infant mortality reviews in communities across the state.
Interviews with families provide some of the richest material in fetal and infant mortality reviews, said Diane Daldrup, who represents the March of Dimes on the blue ribbon panel. She is director of programs and government affairs for the Greater Kansas Chapter.
Through interviews, she said, a community review team can glean detailed information that is not included on a death certificate. And in doing so, Daldrup said, the team can uncover holes in the system that communities can address to improve prenatal services.
For instance, if the mother smoked during her pregnancy, local health officials could consider whether to reassess tobacco use prevention efforts.
Or maybe the team starts to notice a trend of unsafe sleeping arrangements because low-income families can’t afford cribs. Or it may find a lack of prenatal visits because it’s taking 60 days for women to get enrolled in Medicaid.
“Then you take everything that is happening in the community and you develop interventions at the community level,” Daldrup said. “But you also take that data, and it gets drilled up to the state health department where they are beginning to look at themes across the state.”
As nurse manager for the labor and delivery department at the University of Kansas Hospital, Leigh Collins said the Kansas City, Kan., hospital’s specialization in high-risk pregnancies might inflate Wyandotte County’s infant mortality rate.
Record keepers are supposed to attribute the death to the mother’s home county, Collins said, but that does not mean mistakes don’t sometimes occur.
“I have often wondered if those numbers are not somewhat reflected in our mortality because dad may live in Kansas and mom lives in Missouri, or vice versa,” she said.
Like Garrison at the health department, Collins is on the Wyandotte County team working toward winning funding from the two foundations.
And she agreed that interviews with families would provide invaluable information in getting at the root causes of infant deaths.
“Right now,” Collins said, “we only have numbers.”
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783-2529.