A disturbing disparity between black infant deaths and those of other races in New Jersey is the focus of Rutgers conference
While there has been a decline in black infant mortality over the past decade, the difference between black and white infant death rates remain disproportionally high. Black infants in New Jersey die at almost three times the rate of their white counterparts, a disparity that is the second worst in the nation, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics.
In 2014, the most recent year for statistics are available, the non-Hispanic black infant mortality rate in New Jersey was 8.89 per 1000 live births, in contrast to 3.07 for non-Hispanic white infants –better than the respective national rates of 10.93 and 4.89. But there are communities that run counter to such improvement. For example, black infant mortality rates for Camden and Essex counties rose to 12.15 and 10.32, respectively.
Barbara M. Ostfeld, a professor of pediatrics at Rutgers Robert Wood Johnson Medical School and one of the organizers of an upcoming conference on the topic, said the issue was front and center almost 20 years ago when former Gov. Christie Whitman convened a blue-ribbon panel, which resulted in initiatives that helped prevent maternal and child deaths. "Interventions to reduce racial disparities are still needed," Ostfeld said. "While mortality rates have declined, an improvement can never be a signal to stop.”
The conference, Black Infant Mortality in New Jersey: Past, Present and Future, will be held Friday, June 2, at the Robert Treat Hotel in Newark. The daylong event is hosted by The Partnership for Maternal & Child Health of Northern New Jersey and the SIDS Center of New Jersey at Rutgers Robert Wood Johnson Medical School and Hackensack University Medical Center.
Rutgers Today spoke with Ostfeld, who is also program director of the SIDS Center of New Jersey, about this important public health issue and what the organizers hope the upcoming conference will accomplish.
Why is the disparity between black and white infant deaths and those other races so high in New Jersey?
Infant mortality in New Jersey is a study in contradiction. Based on the most recent national data, New Jersey has the third lowest infant mortality rate in the nation. Both white and black rates continue to fall below the national average – with the latter’s the lowest yet achieved in the state. In contrast to a national decline of 19.6 percent in the black infant mortality rate from 2000 to 2014, New Jersey’s rate fell by 35.5 percent and the disparity between the two racial groups decreased by 39 percent. Yet, New Jersey has one of the largest racial disparities of any state, in large part because New Jersey’s white infant mortality rate is the lowest in the United States.
Poverty levels increase infant mortality, and in New Jersey, racial disparities in poverty explain an important part of the story. Based on the U.S. Census Bureau American Community Survey (2009-2013), New Jersey’s black families have over a threefold greater risk of poverty, a ratio that is higher than in most states. Poverty is associated with reduced access to prenatal care, higher rates of smoke exposure –a major elevator of the risk of infant mortality – preterm birth and greater family stress.
What factors do researchers attribute to the racial gap in infant mortality?
Ostfeld: Apart from poverty, one of the major contributors to disparity in infant mortality is smoke exposure. During pregnancy, nicotine can damage the developing brain. Even after birth, exposure has many adverse consequences that put an infant at higher risk for death. Smoking raises the risk of preterm birth, already more common for black infants, and also of SIDS. Although a smaller percentage of black women, compared to white, describe themselves as smokers, black men have the highest rate compared to either white men or women. Since household smoke is the critical measure, a baby whose mother has not smoked is still vulnerable if he or she is in a household with other smokers. In New Jersey in 2015, 24.8 percent of non-Hispanic black males described themselves as current cigarette smokers compared to 15.8 percent of white males. The stress associated with racial discrimination also contributes to preterm birth and, thus, to infant mortality.
What interventions have succeeded in reducing the black infant mortality rate in New Jersey and elsewhere?
Ostfeld: Home visiting programs appear to help families facing the challenges associated with poverty. These programs provide emotional support and guidance and encourage continued prenatal care. A recent study estimated that participation was associated with 24 percent less tobacco smoke during pregnancy, a 15 percent reduction in preterm births and a 45 percent reduction in infant deaths. In New Jersey, the Strong Start program found reduced adverse birth outcomes for black women. With respect to the challenges of poverty, which disproportionately affect black families, an increase in the minimum wage may prove helpful. In a national study, a one-dollar increase in minimum wage above the federal level was recently associated with a 4 percent decline in infant mortality from one month to 1 year of age.
New Jersey has the lowest rate of sudden unexpected infant deaths in the U.S., a category of deaths comprised of SIDS and other sleep-related infant deaths. And, in contrast to recent national black infant mortality rates for this grouping, which have remained static, New Jersey’s continued to decline. Reductions in these deaths have been associated with the vigorous safe sleep campaigns provided by the SIDS Center of New Jersey in collaboration with its many public health, medical and social service partners. New Jersey programs such as Mom’s Quit Connection offer smoke-ending programs to individuals and systems throughout the state.
What do organizers hope will come out of the June 2 conference?
Ostfeld: The conference will bring together clinicians, researchers, public health specialists, faith-based leaders, community service groups, policymakers and legislators to create an infant’s bill of rights and a pathway to achieving it. By identifying what has worked, what needs now exist, what approaches and collaborations are most promising and what further resources may be needed, the conference participants expect the program to be a first step toward an ongoing process. Previous improvements show us that change is possible. From that comes the expectation that even more can be done and must.
– Carla Cantor
For media inquiries, contact Carla Cantor at 848-932-0555 or ccantor@ucm.rutgers.edu.