Every now and then, we come across a statistic that makes us do a double-take. It happened again this week.
In Charlotte, black babies are almost five times more likely to die before age 1 than white babies. Five times? How is this possible in today’s world?
In 2016, 2.9 white infants died for every 1,000 live births in Charlotte. But 13.8 black infants died for every 1,000 live births, or 4.8 times more.
In Raleigh, a new study this month found similar numbers for Wake County – 3.0 white babies and 13.6 black babies died for every 1,000 births in 2016.
Some other troubling numbers: Mecklenburg County’s overall infant mortality rate in 2016 was 7.0 per 1,000 births – up from 6.2 in 2013 and 6.3 in 2014. Compare the 2016 Mecklenburg numbers with 2008, and you find that while the white mortality rate has dropped from 4.4 to 2.9, the black rate has actually risen from 10.4, so the gap between the two has widened.
Racial disparities in infant mortality persist around the nation. But the gap nationally is closer to two-to-one, not five-to-one.
“That’s a crisis. That’s unacceptable. Everyone in government should be really upset about that,” Sarah Verbiest, director of the Jordan Institute for Families at the UNC School of Social Work, told the Observer editorial board.
The causes are complex, systemic and rooted in social structures from past generations. That means that while there may be fixes, there are no easy ones.
Part of it is the economic gap between blacks and whites. Part of it is access to providers – there are zero practicing OB/GYNs in about a third of North Carolina’s counties.
Experts cite other “social determinants,” things like sound housing, safe neighborhoods, stable jobs, diet and transportation. Stress or trauma during a pregnancy can lead to premature delivery.
Verbiest argues that racism – implicit or not – contributes significantly to the problem.
“There’s implicit bias in health care, assumptions providers may make subconsciously about who needs what service or who to listen to when they say they are having a problem,” she said.
That, she says, is why a white woman without even a high school degree is more likely to deliver a healthy baby than a black woman with a master’s degree.
Mecklenburg health officials say preliminary numbers suggest there was a big drop in blacks’ infant mortality rate in 2017, but there is more to be done statewide. One step, lobbyist Alex Miller argues, is to remove some of the tight restrictions midwives and advanced practice registered nurses face in North Carolina, which would provide more access to care in rural areas. Verbiest urges health care systems, governments and others to examine their data to identify where there are differences in care.
Much of the solution on infant mortality might require the same kind of work that Charlotte is doing to improve economic mobility. That problem, it turns out, is not just about working your way toward a better standard of living. For the youngest, it’s about life and death.