Karen Bouffard, The Detroit News, January 30, 2014
Like most new moms, 19-year-old Alaina Gonville loves her newborn son, Brandon, with all her heart.
But like so many babies born in Detroit, little Brandon has faced more than his share of challenges from the minute he entered the world five weeks early, on Oct. 28, at Harper University Hospital.
More babies, like Brandon, are born prematurely in Detroit than in any major city in the United States, a Detroit News investigation found.
Prematurity, whose deadly side effects include brain hemorrhages, collapsed lungs and failing organs, is the leading killer of Detroit’s babies. It’s the major component of infant mortality — a catch-all term comprising all conditions that claim children before their first birthday.
Infant mortality is the No. 1 killer of Detroit children; violence is second. In 2011 alone, 130 of the 208 Detroit children who died that year had not yet marked their first birthday.
The News found that Detroit has more babies born to moms who are under 20, like Gonville, and to single women, than in any other major American city. And often, those young women are not themselves in good health and otherwise ill-equipped to have babies.
The challenges of caring for an infant are daunting in one of the nation’s poorest, most violent cities. Detroit’s infant mortality rate is the worst among big U.S. cities, and worse than some Third-World countries: 13.5 for every 1,000 live births in 2010, the most recent year for which comprehensive data are available.
Foundations, hospitals, social service and government agencies are attempting to tackle the problem through nurse visits, parenting programs and even special tests and treatment for physical conditions found more frequently among black Detroit women. The W.K. Kellogg Foundation alone invests $25 million annually in grants to projects that improve health and well-being in Detroit.
The cocktail of remedies can’t come fast enough: 2,300 Detroit babies died before their first birthday between 2000 and 2011, the most recent year data are available from the Michigan Department of Community Health.
Factors include pervasive poverty, young and uninformed mothers, poor prenatal care and even race.
Experts blame a confluence of health risks for Detroit’s high infant mortality rate, including inadequate health care, information, support and know-how by young mothers.
Eighty percent of new Detroit mothers are unmarried, compared with 42 percent of all Michigan moms, which may mean they have less support — financial as well as emotional — than women with husbands. Also, the city has more teen moms than any other in America: 18 percent.
Exacerbating the situation: The city has a shortage of primary care physicians, and not all accept Medicaid. Pregnant women are challenged to find safe housing, healthy food and transportation.
Detroit’s high concentration of African-Americans may also play a role in the city’s infant mortality rate, because preterm births are more common in African-Americans for reasons not fully understood.
African-American babies also face greater risks of death in their first days of life, according to Romero.
“There is an ethnic disparity,” Romero said. “If we look at the period from birth to 28 days, African-Americans have a mortality rate that’s approximately double of Caucasians.”
Michigan is expanding by nearly 500,000 the number of state residents eligible for Medicaid. That expansion takes effect April 1 and could have significant impact on Detroit’s infant mortality problem, said U-M’s Dr. Davis. Gov. Rick Snyder also has made infant mortality a priority, and a state Infant Mortality Reduction Plan was developed in 2012.
According to Davis, women who are not pregnant or nursing are currently ineligible for Medicaid, and as a result, many low-income women enter pregnancy in poor health. Mothers are then kicked out of Medicaid coverage just weeks after delivering their babies, he said.