infant mortality

Here's an issue that should be tackled as this shameful statistic indicates that we need to do more in District 4 to alleviate poverty.
Infant mortality rate doubles in WorcesterCity’s 13.9 deaths per 1,000 births leads state

By Elizabeth Cooney Telegram & Gazette Staff and Kate Plourd SPECIAL TO THE TELEGRAM & GAZETTEecooney@telegram.com


BOSTON— Worcester’s infant mortality rate more than doubled from 2004 to 2005, reaching 13.9 deaths per 1,000 live births — the highest rate in the state, according to the state Department of Public Health. The city’s rate is up from 6.6 in 2004, with a three-year average of 8.2 deaths per 1,000 births, the DPH said in releasing its annual infant mortality data yesterday. Bruce Cohen, director of the division of research and epidemiology at the Center for Health Information, told the state public health council yesterday that although the trend is not statistically significant, the state needs to watch communities such as Worcester and Springfield

Springfield’s mortality rate was 10.6 deaths per thousand in 2005, the state’s second highest. The statewide rate in 2005 was 5.1, up from 4.8 in 2004. Julie Wisniewski, director of the Worcester Healthy Start Initiative, said that although the new data is alarming, the three-year average shows that the rate has stayed fairly consistent. The Worcester initiative is a federally-funded program that helps women get pre- and post-natal health services and is available for free to all pregnant women and families with babies under two years in Worcester.

Ms. Wisniewski said many women served by the initiative have problems getting proper health care because of cultural and language barriers. “People who are enrolled and participate in our program have healthier babies than other women in Worcester,” Ms. Wisniewski said. A preliminary analysis by the state could find no evidence that mothers or newborns in Worcester received inferior care during birth or in the weeks following. State authorities reviewed births to mothers from surrounding communities who delivered at the same hospitals as the women from Worcester and could find no similar spike in infant deaths. “So it does not appear to be an issue of access to higher medical care,” Sally Fogerty, an associate state commissioner of public health, told the Boston Globe. Dr. Marianne E. Felice, chairwoman of pediatrics at University of Massachusetts Medical School and longtime member of the Worcester Infant Mortality Reduction Task Force, said the high rate of infant mortality in Worcester in 2005 was caused in part by the high number of multiple births — twins, triplets or more — compared to the year before.

Thirty-six infants born in Worcester died before their first birthday in 2005, compared to 17 in 2004. Of the 2005 deaths in Worcester, 12 were from multiple births; only two were from multiple births in 2004, she said. Twins and triplets are at greater risk of being born prematurely, which means they are more likely to have a dangerously low birth weight, among other problems. Massachusetts has the highest incidence of multiple births in the country, said Dr. Dale Magee, a Shrewsbury gynecologist and vice president of the Massachusetts Medical Society. That stems from two factors: Mothers in Massachusetts tend to be older, and older mothers tend to have more twins.

The other reason is that because they are older, there’s a higher incidence of infertility. Massachusetts, one of the few states to mandate infertility coverage by insurers, has the highest rate of in vitro fertilization in the country. “That’s becoming a greater issue for infant mortality, especially for prematurity,” Dr. Magee said. “Across the state, nearly 30 percent of infant deaths occur among multiple births.” Other factors are associated with infant mortality, including poverty, smoking, marital status, education and other socioeconomic forces. But even when these elements are accounted for, the problem persists, Dr. Felice said. Stubbornly high infant mortality rates in the early 1990s led to the Worcester Healthy Start program. “We’re not happy with the numbers,” Dr. Felice said about the 2005 rates.

“We can explain them. We believe this is right in line with what we’ve been seeing before, and we have a plan in place to investigate the problem with more depth over the next year.”

Lynne Simonds for District Four