Richmond infant-mortality rates decline

Fewer infants died in Richmond last year than the previous year, and city health officials credit a comprehensive effort involving multiple city agencies and community partners.

The infant-mortality rate was 10.9 deaths per 1,000 live births in 2008, a decline from a rate of 12.4 deaths per 1,000 in 2007. In actual numbers, there were 36 infant deaths in 2008, compared with 41 in 2007.

"Isn't this remarkable?" Dr. Donald Stern, Richmond City Health District director, said yesterday at a quarterly meeting of the Richmond Healthy Start Initiative Consortium, which brought together many of the city's partners working to combat infant mortality.

The city's African-American infant-mortality rate, often twice as high or higher than the white infant-mortality rate, also dropped, going from 18.9 per 1,000 in 2007 to 11.9 per 1,000 in 2008.

"We still have some work to do," said Stern, noting that the overall rates are still too high and the goal is to match the state rate. The state's infant-mortality rate also was down last year, 6.7 per 1,000 in 2008, compared with 7.7 per 1,000 the previous year.

Health officials also noted that the city's federally funded Healthy Start program has gotten continuation funding of $4.5 million over five years. The federal money is available to localities with an infant-mortality rate 1.5 times the national average. The most recent national rate is 6.69 infant deaths per 1,000 live births.

Stern and Rose Stith-Singleton, director of the Richmond Healthy Start Initiative, said some methods and practices that have helped drive down the rate include emphasizing early and continuous prenatal care, case management, emphasizing best practices with providers, and home visitation.

City health data show at least nine of the deaths were related to extreme prematurity. Also, at least 15 infants were born weighing less than 2.2 pounds, and many were carried less than full term.

"We know that about a third of the infant deaths that occur in our community are a function of what women bring to their pregnancy -- broken relationships, obesity, diabetes, other poor health conditions -- some of which they have control over," Stern said.

Other causes, such as smoking and sudden infant death syndrome, are addressed by education programs. The "back-to-sleep" initiative, for instance, educates parents and caregivers to put babies on their backs to sleep.

Infants put to sleep on bedding that is too soft or in beds with adults also can be at risk. Registered nurse Laurinda Finn-Davis described a young woman she worked with who lost two babies in two years. The first time was a co-sleeping situation where there was one bed for the mother and her four children. The second time, it's believed the baby suffocated on a stuffed animal placed in the bed, and the apartment had high temperatures.

"She was poorly educated," Finn-Davis said of the mother. "She didn't have knowledge about these risk factors. . . . She was doing the things she thought were the right things to do."