Report: Some Utah babies more at risk of dying before first birthday
SALT LAKE CITY —Babies born to African-American and Pacific Islander mothers in Utah have a greater risk of death before their first birthday than other Utah babies due to circumstances that are in some cases preventable, according to the Utah Department of Health.
"One adverse outcome that might have been prevented is already too much," said Jake Fitisemanu, outreach coordinator with the state's Office of Health Disparities. He said infant mortality rates among Pacific Islanders and African-American Utahns are nearly double that of the rest of the population, at almost 10 percent.
"It wasn't just a little blip in the numbers," he said. "It has been a trend for quite a while — one that we haven't seen a great reduction in."
In addition to a greater prevalence of infant deaths, 11.5 percent of babies born to African-American mothers in Utah were preterm, much higher than the rate of preterm births among non-Hispanic whites, which was 9 percent, the report states.
Just 45.4 percent of Pacific Islanders and 59.8 percent of African-American mothers-to-be in Utah seek medical care in the first trimester. About 78.8 percent of the non-Hispanic white population participates in the recommended schedule for prenatal care, beginning early in the pregnancy, according to health department data.
Few of the women in the study were aware of the importance of taking folic acid or a multivitamin before and during pregnancy to prevent birth defects.
"They tend to depend on family members and their elders to tell them what they should be doing. They go to their grandparents and mothers who have raised a lot of children and they rely on that experience," said Joyce Ah You, executive director of the Queen Center, a nonprofit cultural outreach organization that aims to educate the Pacific Islander population about health disparities.
Ah You's daughter was healthy for the most part and yet, years ago, lost her own daughter — her firstborn — at nine months of gestation.
"The day of her baby shower, she went to the doctor and there was no heartbeat," Ah You said. "It was devastating."
While that loss was difficult to accept, Ah You said doctors identified specific genetic issues that have sent her daughter to the hospital for an early, albeit safe delivery for the following five children.
"She would've never known she was high-risk," Ah You said. "She's taken every precaution whenever they were planning to have another child to make sure everything was healthy and taken care of."
Ah You, a Samoan living in Cedar Hills, works on a community task force to help spread the word about the health disparity, among others, and said knowledge can be empowering.
"We are already starting to see a difference," Fitisemanu said. "Just having them there and talking about a subject that is sensitive and in some cases thought of as culturally taboo is much more effective than something coming down from the big, bad health department."
Health department investigators compared data from the birth certificates of infants born to white, Pacific Islander and African-American women in Utah in 2012, as well as birth and death certificates of mothers who experienced a poor birth outcome from January to August of 2013.
The mothers were asked about "virtually every aspect of their lives in the year leading up to a poor birth outcome," the report states.
The study reveals apparent trends among working and living conditions, income, social support and access to health care, among others, also pointing out that "every pregnancy is different and every woman is different."
Compared with whites, both Pacific Islander and African-American mothers had higher rates of obesity, gestational diabetes, chronic hypertension, preterm birth history and shorter intervals between children, in addition to a more widespread lack of proper prenatal care.
Existing health conditions during pregnancy can increase the risk of stillbirth and preterm birth, disease, birth defects and infant mortality.
Many of the women surveyed said they felt uninformed and unprepared when they experienced poor birth outcomes a second time. They also expressed ambivalence about family planning measures, the report states.
While the numbers of Utahns impacted may seem small, Fitisemanu said the prevalence of poor birth outcomes within the identified communities makes it more of an urgent issue.
"This issue exists, but it can be addressed," he said.
With the help of medical businesses and industry partners, as well as church groups and local organizations such as the Queen Center, the health department plans to disseminate information about healthy pregnancies in culturally responsible ways, and in multiple languages so it can reach more people.
The report provides specific recommendations for health care providers, public health agencies and community organizations that work with African-American and Pacific Islander women and families. For a copy of the report, visit www.health.utah.gov/disparities/data/RestoftheirLivesStudy.pdf. For more information on health disparities, visit www.health.utah.gov/disparities.
"Bringing awareness and educating are keys with any society," Ah You said. "A lot of times people don't know there is a problem and then they don't know it could sometimes be prevented."
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