infant mortality rising in wnc

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IN TODA Y’S PAPER NewsPoll at CITIZEN-TIMES.com  TODAY’S POLL: Do you think enough is being done to prevent infant deaths? Go to CITIZEN-TIMES.com and vote. 2008 ELECTION: New York Gov.Eliot Spitzer spoke to lawyers gathered in Asheville, tout- ing the merits of government regulation to combat corpora te fraud. Three North Carolina gubernatorial candidates attended. Page A2 IMMIGRATION: About 100 people gathered for an anti-illegal immigration rally. Organizers oppose a national immigration reform measure, which could g o before the Senate this week. Page A2 Cha nce of sto rms High 85, Low 59 WEATHER, F6  $1.50 SU ND AY ED IT IO N  ASHEVILLE CITIZEN-TIMES  VOICE OF THE MOUNTAINS CITIZEN-TIMES.com  June 24, 2007 ’ 96 ’9 7 ’ 98 ’9 9 ’ 00 ’0 1 ’02 ’0 3 ’04 ’0 5 5 6 7 8 9 10 11 12 13 14 Infant mortality rate Source: Centers for Disease Control and Prevention, N.C. Dept. of Public Health; R. Bradley/CITIZEN-TIMES Buncombe County WNC North Carolina U.S. Infant mortality rising in WNC ERIN BRETHAUER/[email protected] Christina Rathbone cradles her 4-month old daughter , Catrina Brown, at her home in Candler. Rathbone said without the support she received from the Buncombe County Health Center’s Baby Love program she doesn’t think she would have had a successful pregnancy. By Nanci Bompey [email protected]  ASHEVILLE — More babies are dying in Western North Carolina, and public health experts say they don’t know why. In 2005, WNC’s infant mortality rates were the highest they had been since 1996, and infant deaths in Buncombe County nearly doubled from 2004 to 2005. Similar trends are taking place across North Carolina and the Southeast. While infant mortality rates have fallen dramatically in past decades, the region is now seeing the rates leveling off and even rising in some cases. “The frustrating thing about it is that that drop has just petered out, and we are more in a steady state now,” said Dr. Kevin Ryan, chief Improving mothers’ overall health is key Smart times two: Family blessed with gifted kids By Michael Flynn [email protected]  ASHEVILLE After weeks of buzz about the Smashing Pumpkins’ nine- show run at The Orange Peel, the reunited alterna- tive rock group returned to the stage with a sonic blast Saturday night. A jam-packed crowd welcomed back one of the biggest rock bands of the 1990s, who launched the U.S. portion of their first tour since 2000 at the Biltmore Avenue club. “It’s literally the biggest dream come true,” said Asheville’s Dup Crosson, 22, about the chance to see the Smashing Pumpkins in a small setting in his hometown. “I’ve been a fan for 11 or 12 years.” Taking the stage about 10 p.m. to a sea of upraised arms holding cameras and recording devices, front- man Billy Corgan soaked in the adulation before his booming vocals and the band’s piercing guitar sounds filled the venue. Fans rejoice as Pumpkins rock  JASON SANDFORD/[email protected] Billy Corgan hit the stage with his band, the Smashing Pumpkins, Saturday night at The Orange Peel to kick off a nine-show run at the downtown club. By Jeannine Aversa  THEASSOCIATEDPRESS WASHINGTON — Grand- ma stuffing money under the mattress isn’t the only one living outside the banking system. As many as 28 million people in the United States are forgoing tradi- tional financial institu- tions because of mistrust, cultural and language bar- riers or a belief that by the time all the bills are paid there will be nothing left for an account. That can be expensive and risky. People can run up big fees to cash checks, pay bills and meet their other financial needs. Walking around with large amounts of cash can make them a target for thieves. The bankless are esti- mated to earn hundreds of billions of dollars a year in income. Seeing a business opportunity , banks are try- ing to draw in these p oten- tial customers. So, too, are check-cashing businesses and retailers, including Wal-Mart. According to the Federal Reserve, about one in 12 families — 8.7 percent — does not have a bank account. The number is higher for the poorest — nearly a quarter of families earning less than $18,900, the Fed said, citing 2004 data. The share of families without bank accounts decreased gradually from 1989 to 2001, then leveled off, the Fed said. Millions in U.S. have nothing in the bank SUSAN REINHARDT: Annual trek to Myrtle Beach finds some fashion faux pas. Page G1. B&W PHOTO EXHIBIT: Photographers Tom Mohr and Paul Owen have a new show at the Drew Deane Gallery in Brevard. Page H1. CHECK IT OUT: From interpretative crafts- men to a barnyard with animals, River Bend Farm gives visitors a look at Biltmore Estate as a working farm. Page D1  WEB EXTRA Visit  CITIZEN-TIMES.com/data to see in-depth infant mortality statistics for North Carolina and the United States.  WEB EXTRA Visit our online community, Smasheville.com, for st ories, photos and video from the show. Users can blog on the event , join forums and upload audio, video and pictures . OZONE OUTLOOK  Today’ s ridge tops forecast is: 90 Unusually sensitive people should consider limiting prolonged outdoor exertion.       ▲ Unusually sensitive people should consider limiting prolonged outdoor exertion. 201-300 151-200 101-150 51-100 0-50  Today’ s valley forecast is: 54  TOURISTS MEMORIES: A look at the six teams that have won league championships. Page F1 Family history  woven into chairs    P    A    G    E    G    1  All-WNC track Marley Burns of Carolina Day Isaiah Thompson of Asheville      ▲ Pag es E1, E3 Please see INFANT on A4 DEVELOPMENTS IN IRAQ: Roadside bombers killed seven U.S. troops Saturday , four of them in a single blast near Bag hdad, and an eighth soldier died of a noncombat cause — raising to 25 the number of American soldiers killed this week. Page B8  Tourists OFFICER CHARGED IN SLAYING: A massive search ended in sadness Saturday in Canton,Ohio, when authorities announced they found a body believed to be a pregnant woman who vanished from her home a week earlier. A police officer believed to be t he father of the unborn child was arrested on two counts of murder. Page B8 COLLEGE WORLD SERIES: Oregon State beat the Heels in the opener of the best-of- three finale. Page F1 Please see PUMPKINS on A5

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Page 1: Infant Mortality Rising in WNC

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of the women and children’shealth section at the NorthCarolina Department of Public Health.

While medical care andprograms aimed at improving

birth outcomes have reachedmore mothers, more babiesare being born prematurely orwith low birth weights, whichare the main causes of infantdeath.

In the past, public healthofficials focused on increasingaccess to prenatal and postna-tal care as the way to combathigh infant mortality. Ryansaid that while North Carolinahas made good progress ingetting more women into pre-natal care earlier in theirpregnancies, there hasn’t beenas much improvement ininfant mortality rates as healthexperts expected.

He said more public healthexperts are realizing that the

rising infant mortality ratesare not a result of fewerwomen accessing prenatalcare or premature babies notgetting the help they need.Instead, they are starting tolook to chronic, lifestyle issueslike obesity, diabetes andhypertension to help explainthe increasing number of deaths.

“It’s something that peopleare coming in the door with,”Ryan said. “For some reasonor another they are not asphysiologically able to carrythose babies to term.”

The challenge that facespublic health officials now isdetermining which of thesefactors — from smoking toobesity to chronic disease —has the greatest effect oninfant mortality.

“If you take a thousandwomen who are optimal in allthose ways, that’s not hard toprove that they’re going tohave a better birth outcomethan people who are chal-lenged in all those ways,” Ryansaid. “But teasing out is it part-ly this, is it partly that … thoseare hard things to determine.”

Race, health factorsHealth departments use the

infant mortality rate, or thenumber of deaths by age 1 per1,000 live births, to measure thehealth of a population and the

quality of its medical system.There are many reasons

babies die before their firstbirthday. These include birthdefects, infections, suddeninfant death syndrome andaccidents, but prematurityand low birth weight, whichcan be the products of poorprenatal care, might be thebiggest reasons.

As health care in the UnitedStates improved over the pastseveral decades, infant mortal-ity drastically declined. Therate went from 26 per 1,000live births in 1960 to 6.9 per1,000 live births in 2000. Butsince 2000, the number of infant deaths nationally and inNorth Carolina has remainedrelatively constant.

In 2005, the latest year forwhich data is available,Buncombe County saw infantmortality rates increase to arate of 10.7 from 5.4 the previ-ous year. Infant mortalityrates in the 16-county western

part of the state jumped to 9.8from 6.0 in 2004.

Minority babies also con-tinue to die at twice the rate of white babies, both in WNCand in the United States.

“All over thestate, all over thenation, I don’tcare where youlook, you’regoing to see dis-parities in infantmortality,” saidSharon West,executive director of theAsheville Buncombe Instituteof Parity Achievement.

West said factors fromsocioeconomic status to gen-eral health could contribute to

poor birth outcomes. She saidstudies show African-Americans are also more like-ly to be disenfranchised by themedical system from years of racism and stereotyping andare less likely to receive prop-er medical care.

Dr. Susan Mims, medicaldirector at Mission Children’sHospital and the former med-ical director atthe BuncombeCounty HealthDepartment, saidthese trends arenot unique toWNC.

“The trendsthat we’re seeing

are constant throughout ourregion,” Mims said.

 Janice Freedman, executivedirector of the North CarolinaHealthy Start Foundation, saidthe Southeast has a higherproportion of African-Americans, poor people andpeople living in rural areas,demographics that can allinfluence a person’s access tocare. She said more peoplesmoke, are obese and sufferfrom chronic health problemsin the Southeast than in otherparts of the country.

“We’ll never look like aVermont or Minnesota,” shesaid of the states with lowinfant mortality rates.

Programs to addressthe problem

In 2003, North Carolinaranked 40th in the UnitedStates in infant mortality.

To reduce infant mortality,Freedman said North Carolinahas programs aimed atincreasing access to prenatalcare, promoting a healthylifestyle during pregnancy,reducing smoking and sub-stance abuse and, after a babyis born, helping new parentslearn proper care to reduceaccidents, improve nutritionand reduce sudden infantdeath syndrome.

One of these initiatives isthe Baby Love program inBuncombe County.

The program pairs mater-nity care coordinators withhigh-risk pregnant women.

The coordinators help thewomen find services, includ-ing transportation, housingand domestic violence pro-grams, as well as medical care.

Candler resident ChristinaRathbone, 24, attributes hersuccessful pregnancy to thesupport she received throughthe Baby Love program.

“Anytime I get stressed out,I stop taking care of myself,”she said. “I would have endedup miscarrying or in the hos-pital numerous times if I did-n’t have (Mirlie Greene’s)help.”

Rathbone said Greene, hermaternity care coordinator,helped her deal with emotion-al and physical issues.

“She told me that you needto put yourself first,”Rathbone said. “You need totake care of yourself for yourbaby.”

Even with success storieslike Rathbone and increasedenrollment in these programs,infant mortality rates are notfalling.

“We are doing the rightthing,” Freedman said, “But alot more can be done.”

New approachesFreedman said she doesn’t

think there will be a drasticreduction in infant mortality

rates if North Carolina contin-ues what it has been doing.

Despite having a betterhealth care system andincreased access to prenatalcare, more babies are beingborn premature and at lowerbirth weights than in the past.

Ryan said the rising infantmortality rates are causingpublic health officials to lookfor a new approach.

“I think the original ideawas suspect,” he said. “Theright way to think about it isthat … if you have a lifecyclewhen from birth a person hasbeen exposed to poverty,stress, perhaps poor housing,perhaps poor nutrition,sedentary lifestyle, you’re not

going to correct that witheight months of good prenatalcare.”

Public health experts arenow starting looking at a

women’s entire health leadingup to pregnancy as a factor forinfant mortality. They sayincreased rates of diabetes,obesity, high blood pressureand increasingly sedentarylifestyles may all play a role.

“There are so many factorsthat go into infant mortality,and the general health of awoman going into a pregnan-cy is a huge factor and proba-bly more so than the smallerthings that we’ve addressed inthe past,” Mims said. “I thinkwe still need to continue tofocus on those things thatwe’ve done that have helped,but we need to kind of take astep back and look at the big-ger picture.”

Ryan said initiatives likeGov. Mike Easley’s plan toincrease access to health carefor all children, the GeneralAssembly’s proposal toincrease sex education inschools, programs aimed atreducing unplanned pregnan-

cies, and promoting exerciseand healthy eating are some of the best ways to try to combatinfant mortality.

“It’s not an either-or typeof strategy,” he said. “Infantmortality is a common end-point for a variety of factorsthat can be very different fromeach other. You need a varietyof strategies.”

The challenge that publichealth officials face now isdetermining which of thesefactors are contributing mosttoward the rising infant mor-tality rates and developingthose strategies.

“We should expect moreand we should do better, andwe need to look at every

aspect that we can influence,that we can control, that couldhelp improve the chance thata baby who is born can live,”Mims said.

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Continued from A1

INFANT: Lifestyle issues, socioeconomic factors at play in WNC  WHERE TO GET HELP■ North Carolina Department of 

Public Health: (919) 707-5000.

■ North Carolina Healthy Start 

Foundation: (919) 828-1819.

■ North Carolina Department of 

Health and Human Services:

Women’s and Children’s Health:

(919) 707-5510.

■ North Carolina Department of Health and Human Services:

Women, Infants and Children:

(919) 707-5800.

■ Buncombe County Health

Department: 250-5000.

■ Baby Love maternity care program

in Buncombe County: 250-5689.

■ Smart Start of Buncombe

County: 285-9333.

BY THE NUMBERS■ The infant mortality rate for the

United States was 6.8 per 1,000

live births in 2004.

■ In 2005, North Carolina’s infant 

mortality rate was 8.8 per 1,000

live births.

■ In 2003, Mississippi had the

highest infant mortality rate in thenation at 10.7, while New

Hampshire had the lowest rate in

the nation at 4.0.

■ In 2004, the United States

ranked 35th in the world in terms

of infant mortality.

■ In 2004,Hong Kong had the low-

est infant mortality rate in the world;

Sierra Leone has the highest at 165

deaths per 1,000 live births.

■ In 2005, the infant mortality rate

for white babies in North Carolina

was 6.4 while the infant mortality

rate for non-white babies was 14.9.

■ 20 percent of infant deaths in

North Carolina in 2005 were

attributed to prematurity and low

birth weight.Source: N.C. Department of PublicHealth, Centers for Disease Controland Prevention, United NationsDevelopment Programme.

Sharon West

Susan Mims