By Dianne Anderson

Still way off the charts, the infant death rate for black babies soars over twice the rate of white babies with a statistic that’s barely budged over the decades.

Now that the state of California has cut the cord on the Black Infant Health program, local maternal programs and hospitals may try to pick up the slack in outreach from lost funding for the program.

But that outreach is not mandated.

San Bernardino County ranked among the highest death rate for Black babies at 16.9 deaths per 1,000 compared to 12.4 per 1000 statewide, according to the California Public Health Department. Only San Joaquin and San Francisco counties ranked higher.

San Bernardino County Health Officer, Dr. Maxwell Ohikhuare said that he is very concerned about the Black infant death rate, and added that the county will continue outreach, currently with over 80 percent of women of all races receiving early and full prenatal care.

He’s also attempting to address the disparity by collaborating with other programs, such as the Maternal, Child and Adolescent Health Section, and Prenatal Substance Abuse Program.

“We want to incorporate some of the functions of the old Black Infant Health into these programs, that’s how we’re dealing with it locally,” he said. “We are working with maternal mortality and morbidity labor induction project, which will also help out.”

Recent CDPH statewide data shows that general infant mortality is 5.2 for every 1,000 live births, with white infant death at 4.6 per 1,000 live births. However, Black infant death at 11.5 for every 1,000 live births, with 65 percent of those deaths attributed to very low birth rates of African American babies.

Locally, there has been slight improvement from 2005-2007, bringing San Bernardino County from 16.9 to 15.6 infant death per 1,000 live births.

Dr. Ohikhuare said that low birth rate is frequently associated with preterm birth, which is one reason why Black infants are more at risk.

He added that the county’s Maternal Health program is targeting the problem of elective induction of labor before 39 weeks.

Data shows a higher injury rate of mothers who go through elective induction because of its complications. He said that a new program at the county level will outreach to local obstetricians and work to reduce the number early deliveries.

“Out of ten counties, there are only two counties that are doing this work right now, San Bernardino and Los Angeles.Counties. We’ve developed a tool kit that has been accepted by all maternity hospitals countywide.”

The new approach is expected to be helpful to Black women, who seem to be going through early labor without a valid medical reason for it. Studies show that about one-fifth of all new mothers are prompted to induce birth before their 39th week.

Forcing the baby to come early is risky. Prematurity can be a problem, including fetal death.

Dr. Ohikhuare said that low-income women with limited education are less likely to ask their doctors questions about the risk.

Other common predictors of risk for infant death is that mothers are more likely to have unintended pregnancy, more likely to be poor and with prenatal care covered by Medi-Cal, more  likely to be single, and less likely to have completed high school.

Right now, he said that elective inductions are happening across the county, but San Bernardino County is taking the lead at finding a solution.

The Elective Induction awareness program has received some First 5 funding, he added.

“This allows us to go to different obstetrician offices to educate them,” he said. “If you target physician offices, specifically asking staff to target minority areas where physician are, we can capture a lot of the minority population.”

According to the CDC, “In terms of the health of women and infants, preterm birth is an important public health priority,” said Dr. Eve Lackritz, Chief, Maternal and Infant Health Branch at the Centers for Disease Control and Prevention (CDC). “Preterm delivery is the leading cause of hospitalization among pregnant women, is the most frequent cause of infant deaths, and is a major contributor to the racial disparity in the infant mortality rate.”

The CDC reports that preterm birth has increased over 20 percent since 1990 and over 36 percent in the past twenty years. In 2006 alone, preterm birth rate accounted for 12.8, a figure about the same for 2005, accounting for 545,000 preterm babies out of 4,265,555 births in 2006. The number of preterm birth was disproportionately higher for non-Hispanic Black women.