Indiana’s Labor of Love public health initiative to reduce the state’s infant mortality rate appears to be working, according to a new report.
With 7.6 deaths for every 1,000 live births in Indiana in 2012 — one of the country’s worst rates, according to the KIDS Count Data Book report from the Annie E. Casey Foundation — the number of babies with low birth weight is decreasing significantly statewide and locally. Short gestation and low birth weight — less than 5.5 pounds — is the leading cause of death for infants under 1 year old among all races.
In Lake County, the percentage of babies with low birth weight decreased from 9.8 percent to 8.5 percent between 2009 and 2013. The percentage went up — from 7.2 percent to 7.5 percent — in Porter County during the same time period. Statewide, the rate was 7.9 percent — just a tick below the national average of 8 percent.
In Lake County, the infant mortality rate is 9.8, and among black infants in Indiana, the rate is 14.85 percent. Nationally, the infant mortality rate is 6.1 deaths per 1,000 live births.
Since 2009, infant deaths in Lake County are down slightly — from 53 to 51 in 2013. Statewide the decrease is slightly larger: 675 to 594. In Porter County, the number of infant deaths were static at 11.
Doreen Norris-Stojak, Methodist Hospitals’ director of women and children services, said since Methodist started participating in the March of Dimes’ 39 Week Initiative, it’s seen positive results.
“The 39 Week Initiative aims to eliminate elective deliveries,” Norris-Stojak said. “It has had dramatic effect on us. We’ve seen (neonatal intensive care unit) admissions decline, and it’s made a huge impact.
“At Methodist, we have that as a standard for all moms; it doesn’t matter who your insurance carrier is, if it’s not medically indicated.”
Other top causes of infant mortality include sudden infant death syndrome, congenital anomalies and accidents.
Dr. Valentin Drezaliu, an obstetrician/gynecologist with the Methodist Physician Group, said the guidelines were based on a large review study that found babies suffer fewer complications if they are born after 39 weeks.
“Even after 39 weeks, the consensus is moms should wait to deliver until they are full term,” Drezaliu said. “This really shows the effect of the new guidelines.”
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In addition, Methodist and other hospitals actively promote the Back to Sleep initiative, which aims to educate parents about unsafe sleep positioning — accounting for 15 percent of infant deaths in Indiana.
Norris-Stojak said parents are given a book at discharge that focuses on laying babies on their backs, alone in a crib, which must be emptied of pillows, blankets and other objects that can cause suffocation.
Drezaliu said preventing preterm labor is a big concern for expectant mothers.
“It brings to attention how important accessing care is as soon as a woman finds out she’s pregnant,” Drezaliu said. “There are so many things we can do to prevent preterm labor, including eating healthy. We have a very strong OB service, and our nurses are all for educating moms; it can really make a difference in terms of emotional support.”
Methodist has also worked to improve infant and maternity health by offering prenatal education classes, making lactation consultants available to moms, and offering classes to prepare healthy meals.
Lake County has also seen a precipitous decline in the number of births for moms between 15 and 19 years old. Since 2009, it’s decreased from 46.3 percent to 30.1 percent in 2013. In Porter County, the rate has dipped from 21.7 percent to 18.6 percent in the same period.
Children in poverty
The report shows that Indiana children are making strides in education, but high rates of child poverty are still prevalent in the state. Indiana ranked 32nd nationally in overall child well-being, which was a drop of five spots from the 2014 report. The lower ranking was due more to minor improvements made by other states such as Missouri, Montana, Oregon and New York.
The report gives a picture of how children across the nation are faring by looking at four specific categories when ranking states: family and community, education, health and economic well-being.
Around 345,000 Hoosier children are living in poverty, as the state poverty rate increased to 21.9 percent. The percentage of children in poverty has gone up in Lake County — from 24.8 percent in 2009 to 27.7 percent in 2013. It increased 5 percent to 15 percent in Porter County in 2013.
In Lake County, the number of students receiving free and reduced lunch is 56.7 percent, and 34.5 percent in Porter County.
More children are living in high-poverty areas — from 8 percent in 2008 to 12 percent in 2013.
“It’s disheartening to see this trend get worse since the height of the recession in 2008,” Glenn Augustine, interim CEO of the Indiana Youth Institute, said in a statement. “Historically, poverty lags behind other indicators in a recovery that follows a major economic downturn, and many Hoosier families are still struggling to provide basic living expenses.”
Indiana received its best ranking to date in education at 25th. High school graduation rates in Lake and Porter counties have increased over the past few years. In Lake County, 88.8 percent of students graduated in 2013 compared with 80.2 in 2009. The rate increased from 90.2 percent to 91.5 percent in Porter County.
Math scores are up for all students, but 62 percent of eighth-graders scored below proficient in the subject. The gap in performance between white and Hispanic students is shrinking.
The state is expanding its On My Way Pre-K pilot program to more than 2,000 4-year-olds this fall, but the percentage of Hoosier children who did not attend preschool from 2011 through 2013 — 61 percent — is higher than the national average of 54 percent.
Other areas of improvement include fewer Indiana kids lacking health insurance compared with 2008 — the rate is down 2 percentage points to 8 percent — and the percentage of teens who abused drugs or alcohol fell from 8 percent in 2008 to 6 percent in 2013.