map shows greatest mortality for infants in the southeast
Infant Mortality Rates, US, 2015. Data, map courtesy: NC DHHS

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By Taylor Knopf

In 2016, an average of 331 babies were born each day in North Carolina. And on each of those days two of those babies died.

That results in an overall infant mortality rate that was 7.2 deaths per every 1,000 babies born in 2016. Put another way, seven of every 1,000 infants died in their first year of life.

That’s better than the 2015 rate, which was 7.3 babies per 1,000, but only slightly. And despite the improvement, North Carolina has one of the worst infant mortality rates in the nation, ranked 7th from the bottom.

“This is a great concern for us,” said Karen McLeod, chair of the Child Fatality Task Force which hosted their annual presentation of the infant mortality data on Wednesday.

“We really want to see changes moving forward that address those numbers,” McLeod said.

Racial disparities

Of ongoing concern is the disparity between infant mortality rates in whites and blacks, Watkins pointed out. In 2016, African American infants were 2.7 times more likely to die in their first year of life compared to white infants.

“There is definitely a disparity in mortality rates and… this disparity has persisted over time,” she said looking at data from 2007 to 2016.

In the past, North Carolina Health and Human Services Sec. Mandy Cohen has pointed out that this rate puts the black infant mortality rate in the state on par with that of Mongolia.

Stephanie Watkins, an epidemiologist in the Women’s and Children’s Health Section of the Division of Public Health, said it’s difficult to discern much about the Native American infant mortality rate in North Carolina due to the relatively small population and sporadic data.

The evidence shows racial disparities are widening. From 2015 to 2016, the mortality rate for white infants in the state declined by 12.3 percent. During the same period, the mortality rate increased by 7.2 percent for African American babies and 11 percent for Hispanic infants.

The goal is to reduce the disparity between African American and white babies by the year 2020.

Not really budging

On a positive note, the number of births to teenage mothers in North Carolina has been cut in half over the past decade.

“If you look at the gap between teen birth rate in North Carolina in the late ’90s and you compare that to the U.S. rate at the time, the gap was much larger,” Watkins said.

About 10 years ago, the teen birth rate in North Carolina was 19 percent higher than the U.S. average. In 2016, North Carolina’s teen birth rate is only 7 percent higher.

Despite improving numbers nationwide for younger women, the overall infant mortality rate across the U.S. was 5.90 per 1,000 births in 2015, with Southern states – except for Virginia and Florida – generally having worse outcomes.

The state goal was that by the year 2020, North Carolina’s infant mortality rate would have dropped to 6.3 per every 1,000 live births, Watkins said. But improvement has stagnated since 2010, and as 2020 gets closer, that goal appears more out of reach.

In 2016, the leading causes of death for an infant were prematurity, low birth weight and birth defects, with 68 percent of infant deaths taking place during the neonatal period, which is the period within four weeks of birth.

More babies in North Carolina were born at a low birth weight, a rate that’s 12 percent above the national average in 2016.

“The numbers (of infant mortality) are greatest in the eastern part of the state,” said McLeod. “There seems to be a correlation around poverty in that area as it relates to death. This is something we really need to look at and investigate further and see what kind of interventions can be put in place to move North Carolina to a better place.”

She added that the number of physicians to support pregnant mothers in the eastern part of the state is “woefully low” and the task force is looking for ways to bring more to those areas. McLeod said women often end up having to go one or two counties away to see an obstetrician.

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Taylor Knopf

Taylor Knopf writes about mental health, including addiction and harm reduction. She lives in Raleigh and previously wrote for The News & Observer. Knopf has a bachelor's degree in sociology with a...