Alabama's infant mortality rate on the rise

After almost a decade of steady decline, figures released by the Alabama Department of Public Health indicate infant mortality rates in the state and in one local county are once again on the rise.

The report, which compiled numbers through 2007, shows that for every 1,000 live births in the state, 10 of those babies will not live to their first birthday. This is up from 9 per 1,000 in 2006.

The figure also puts Alabama ahead of the rest of the country, where infant mortality rates stand at 6.6 deaths for every 1,000 live births.

Dr. Don Williamson, health officer for the Alabama Department of Public Health, said the statistics are disheartening, especially after years of seeing rates of infant mortality drop. And although the news is not good, he said the state is already working on what can be done to resolve the problem.

"If you look at what seems to be driving infant mortality rates, the first obvious problem is the dramatic decrease over the last four years in the percent of women who get adequate prenatal care, so that in 2007, less than 73 percent of pregnant women got adequate prenatal care," Williamson said.

The figures also indicate there are other issues the state must contend with when it comes to the overall health of its residents, he said.

"The fundamental question is that this is not a disease, but it's a marker for major problems in our society," Williamson said.

A lack of prenatal care is one of many reasons Williamson said we're seeing a rise in infant deaths, and additional problems come from moms who smoke while pregnant, the mother's education level and even the birth order of the child.

"There is also a growing number of uninsured people, whether that's because they are undocumented persons or people who had insurance and have gotten laid off and no longer have it," Williamson said. "As the number of uninsured people climbs, there's a finite amount of uncompensated care the health-care system can manage."

There are ways to solve the problem, he said, but they could be costly at a time when there are little additional financial resources to go around.

"We've got to look at expanding prenatal care to cover uninsured moms and one way to do that is to expand the children's health insurance program to cover unborn infants," he said. "The reality is that this would allow us to cover almost all moms who get no prenatal care. The challenge is money, and now is certainly a tough time to be looking for additional dollars."

Infant mortality rates also are higher in Colbert County than in the past. In Colbert, 654 babies were born in 2007, and eight of them died. This is up from 2006, when 625 babies were born and six died. Colbert is the only Shoals area county that saw a rise in rates.

"We don't have a clear answer at this point as to why this is," said Dr. Karen Landers, area health officer for the state health department.

"In my 27-year career, we've made a lot of progress. Infant mortality rates had been as high as 12 or 13 per 1,000 live births. In Colbert, we haven't seen a decline in access to care, so we're not sure what's going on, and that's why we're concerned."

Compounding the problem is the corollary between higher infant mortality rates and pregnancies among teenage girls.

A separate report released by the health department reveals that teen pregnancies also rose in 2007, to 39.7 percent, slightly up from 2006 and 2005 rates of 39.6 percent and 39.5 percent, respectively.

In 2007, 112 babies were born to mothers between the ages of 10 and 19 in Colbert County, which is up from 80 in 2006. In Franklin County, 66 babies were born to teenage moms in 2007, down from 77 in 2006. In Lauderdale County, there was also a decrease in teen pregnancies; 130 babies were born to teen moms in 2007, down from 149 in 2006.

Jamie Keith, director of the Alabama Campaign to Prevent Teen Pregnancy, said the correlation between teen pregnancy and infant mortality rates exists because of the age and educational level of the mother.

"Sex education is not mandatory in public school, so it's not required that adolescents receive pregnancy prevention information or education," she said, adding that programs developed around the needs of each community could lead to better prevention and fewer teen pregnancies. Among certain demographics, the statistics on infant mortality rates present a mixed story.

Among blacks, for instance, 14.6 babies per 1,000 live births end in death, but that's down from a high of 16 babies in 1999. Rates among white mothers were up significantly, however, at 8 deaths per 1,000 live births, which is the highest it's been in 10 years.

One new phenomena that appears to cross racial lines is the overall health of the mother as becoming a factor in increased mortality rates. Williamson said unhealthy moms, including those who have been diagnosed with obesity, diabetes or high blood pressure, can be more likely to lose an infant child.

"Alabama ranks in the Top 5 in obesity, and there are now credible studies that show obese moms, when they get pregnant, are more likely to lose a child in the first year of life, so we suspect that obesity in women contributes to infant mortality," he said.

As Williamson and others at the state and local health departments begin to tackle the problem, he said an infant mortality review is under way that will help health-care professionals understand why some moms lose babies.

Michelle Rupe Eubanks can be reached at 740-5745 or michelle.eubanks@TimesDaily.com.