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Perspective | NC’s outrageous racial gap in infant deaths persists

The North Carolina Department of Health and Human Services recently released data regarding infant deaths in 2019. With coverage of the COVID-19 pandemic continuing to dominate the attention of the media and the public alike, the release of the new data wasn’t highly publicized.

But it may also be because the data are so deeply disappointing. In 2019, North Carolina’s overall infant mortality rate was 6.8 deaths per 1,000 births, higher than the national average of 5.7 deaths per 1,000 births. Even more disappointing is the recent data that confirms the state’s racial gap in infant survival continues to persist.

The 2019 data show that the rate of Black infant deaths was 2.66 times the rate for white infants, one of the widest disparities ever recorded in North Carolina, and 12% more than the rate two decades ago. The issue of infant mortality continues to disproportionately impact communities of color, and this past year, we’ve seen the same racial inequity related to COVID-19 cases and deaths — Black, Indigenous, and Latino Americans all have a COVID-19 death rate of more than 2.7 times white Americans. So many of these deaths — as with infant mortality — are preventable, thus making them all the more tragic, and unacceptable.

Racial disparities have long plagued the state’s infant mortality and many other health indicators, now including those associated with current pandemic. And at the same time, as with COVID-19, we know how to prevent many infant deaths. Other states have prioritized addressing racial gaps in infant deaths and have moved to expand Medicaid, address the impacts of racism on birth outcomes, and implement a number of policies that improve family economic security. Here in North Carolina, it is beyond time to implement critical policy interventions that we already know will work to prevent unnecessary infant deaths.

Preventing infant deaths

Infant mortality is a complex problem embedded in structural racism and income inequality. Nevertheless, there are multiple solutions that can save babies’ lives. For North Carolina, there is a general consensus on the need for interventions in the following areas:

Improving health care for women.

  • Medicaid expansion would improve overall health prior to pregnancy and increase access to prenatal care. Recent studies continue to demonstrate that expanding Medicaid means more moms get prenatal care on time. Getting health coverage to more moms also improves health outcomes for newborn babies.
  • An additional recommendation is to extend postpartum coverage for Medicaid recipients from six weeks to one year. This ensures that new mothers have ongoing access to the physical and mental health services they need to stay healthy and raise healthy babies.

Strengthening families and communities.

  • One example is ensuring that employers provide basic accommodations for pregnancy and breastfeeding in the workplace. Establishing reasonable accommodations that support the health and safety of workers who are pregnant or nursing helps keep these individuals in the workforce – and their babies safer.

Addressing economic and social inequities.

  • This includes increasing wages so that families can afford basic needs, parental leave, affordable and available child care, and reduced exposure to environmental hazards.

North Carolina’s infant mortality problem is one that we can solve. Evidence-based interventions like these would help save babies’ lives, and address the glaring racial disparity that continues to plague our state.

At NC Child, we’re committed to advocating for many of these policies in 2021 and beyond. As we continue to face the devastating impacts of COVID-19, it’s time for action from our elected officials, state leaders, and business community. We all have a role to play, and we need to do it collaboratively in order to make the outrageous racial disparity in infant deaths a thing of the past.

Tom Vitaglione

Tom Vitaglione has spent the last four decades fighting for the health and safety of North Carolina’s children. As NC Child’s volunteer Senior Fellow, Tom is one of the state’s leading voices for maternal and child health. Tom received his MPH from Columbia University. He is passionate about the Yankees, Knicks, Rangers, and Giants, and has more awards named after him than anyone else in the NC Child office.