Health Forward Foundation

Kansas Ranks 40th in Infant Mortality

United Methodist Health Ministry Fund and the Kansas Health Foundation to fund intensive local studies into the causes of infant deaths

For health officials, the death of a baby is more than just a loss for the parents.

The ripple effect could drive mental health needs for grieving households.

The death could also highlight a lack of education among new moms about safe sleep practices for the infant.

Or, it could signal a gap in a community’s prenatal services. And that, in turn, could mean expensive treatment in neonatal intensive care units and costly education supports later on if those babies are developmentally disabled.

“I think it’s important to find out why we lose our babies,” said Terrie Garrison, program manager for the family planning/prenatal clinic in the Public Health Department of the Unified Government of Wyandotte County/Kansas City, Kan.

Wyandotte County may get that opportunity, and the first step could come later this month.

That’s when the United Methodist Health Ministry Fund and the Kansas Health Foundation expect to solicit proposals as part of their five-year, $900,000 initiative to fund intensive local studies into the causes of infant deaths. The studies are called fetal and infant mortality reviews.

The foundations announced their plan at a May meeting of the Kansas Blue Ribbon Panel on Infant Mortality.

They expect to make their funding decisions by around Thanksgiving, according to panel member Shannon Cotsoradis, the chief executive of Kansas Action for Children. She said the foundations expect to choose up to three winners from five counties targeted for their high infant mortality rates: Wyandotte, Geary, Saline, Shawnee, and Reno.

According to the latest data available from the Kansas Department of Health and Environment, Wyandotte lost 8.5 babies for every 1,000 live births in 2010. The statewide rate of 6.3 per 1,000 live births was the lowest since record keeping began in 1912.

But that success came on the heels of the state’s recent history of lagging behind the rest of the country. Kansas was ranked 40th among all states in 2009, according to the blue ribbon panel.

The Governor’s Office established the task force three years ago, and among its recommendations issued in February 2011, was a call to establish fetal and infant mortality reviews in communities around the state.

Interviews with families that have had a baby die provide some of the richest material in fetal and infant mortality reviews, said Diane Daldrup, who represents the March of Dimes on the blue ribbon panel. She is director of programs and government affairs for the Greater Kansas Chapter.

Through interviews, she said, a community review team can glean detailed information that is not included on a death certificate. And in doing so, Daldrup said, the team can uncover holes in the system that communities can address to improve prenatal services.

For instance, if the woman smoked during her pregnancy, then perhaps local health officials need to reassess their education efforts in that regard.

Or maybe the team starts to notice a trend of unsafe sleeping arrangements because low income families can’t afford cribs. Or, maybe they find a lack of prenatal visits because it’s taking 60 days for women to get on the Medicaid rolls.

“Then you take everything that is happening in the community,” Daldrup said, “and you develop interventions at the community level, but you also take that data, and it gets drilled up to the state health department where they are beginning to look at themes across the state.”

As the nurse manager for the Labor and Delivery Department at the University of Kansas Hospital, Leigh Collins speculated that the hospital’s specialization in high-risk pregnancies from around the region might inflate Wyandotte County’s infant mortality rate.

Record keepers are supposed to attribute the death to the mother’s home county, Collins said. But that does not mean mistakes don’t sometimes occur, she said.

“I have often wondered if those numbers are not somewhat reflected in our mortality because dad may live in Kansas and mom lives in Missouri, or vice versa,” she said.

Like Garrison at the health department, Collins is on the Wyandotte County team working toward winning funding from the two foundations.

And she agreed that interviews with the families would provide invaluable information in getting at the root causes of infant deaths.

“Right now,” Collins said, “we only have numbers.”

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