Why is the infant mortality rate higher among African-American babies?

By Briana Vannozzi

The rates are alarming. Black babies in New Jersey are three times as likely to die in infancy as white newborns. Although the state’s made great strides in the last decade to lower the overall black infant mortality rate — in fact ours is the lowest in the nation — there’s still a great divide among ethnicities.

“Twenty years ago we recognized in the state of New Jersey that black infants were dying more frequently than their white counterparts and it couldn’t be attributed to the mother’s income, her education or her marital status,” said Ilise Zimmerman, executive director of the Partnership for Maternal and Child Health of Northern New Jersey.

2014 data from the Centers for Disease Control and Prevention breaks it down further. Statewide the black infant mortality rate was 8.89 per 1,000 live births compared to just over 3.07 per 1,000 births for white, non-Hispanic infants. That’s an overall decline of 35.5 percent since 2000, but the disparity is the nation’s second highest.

“What I do as a physician accounts for about 20 percent of people’s health and well-being. Larger social forces, jobs, housing, nutrition contributes about 40 percent to people’s overall health outcomes. We need to address these issues if we’re ever going to get to a place where we have equal levels of infant mortality between blacks and whites in the U.S.,” Professor of Community Medicine and Family Health at Rutgers Robert Wood Johnson Medical School, Dr. Denise Rodgers.

To tackle these social determinants, state health leaders held a conference in Newark today. It was a gathering of the minds to find solutions.

“Poverty is very critical because your ability to have resources for adequate housing, for sufficient food for yourself, for the ability to protect your baby by being in neighborhoods that are safer, those things matter. And when you don’t have those opportunities your stress level goes up and stress hormones are very important, critical factors that can contribute to a preterm birth,” said Robert Wood Johnson Medical School Pediatrics Professor Barbara Ostfeld.

Stress is a big one, but there are other factors like substance use, even compliance with safe sleep habits which tend to be higher in these communities.

“We have a big neonatal intensive care. We have 50 beds. We take care of a lot of critically ill newborns, half of those are premature, many of them are in fact black,” said Dr. Morris Cohen, director of neonatal medicine at the Children’s Hospital of New Jersey.

A prime example of the disparities lies in opposite ends of the state. In Camden County, the rate of black infant mortality is even higher — 10.32 per 1,000 live births. In Essex County, it’s higher yet — 12.15 per 1,000 births.

How do you tackle this when so many of the programs being discussed are having threats of budget cuts?

Lisa Asare from the state Department of Health said, “There’s strength in numbers. I think just what I said is how we tackle it, by really working collaboratively. Different people have different strengths, the funding is shrinking so the only way we can really do it is if we divide up the work and try and work more collectively.”

The real hard work comes after the conference when all these stakeholders will be tasked with translating this data and scientific knowledge into clinical and public health practices.