Progress Pond

Infant Mortality Soars in the South

Don’t get me wrong. This is not a post meant merely to bash either the South as a region, or Southerners, in general, as being less concerned about human life. However, it is deeply disturbing that infant mortality rates in southern states have soared recently (via The New York Times):

HOLLANDALE, Miss. — For decades, Mississippi and neighboring states with large black populations and expanses of enduring poverty made steady progress in reducing infant death. But, in what health experts call an ominous portent, progress has stalled and in recent years the death rate has risen in Mississippi and several other states. […]

“I don’t think the rise is a fluke, and it’s a disturbing trend, not only in Mississippi but throughout the Southeast,” said Dr. Christina Glick, a neonatologist in Jackson, Miss., and past president of the National Perinatal Association.

To the shock of Mississippi officials, who in 2004 had seen the infant mortality rate — defined as deaths by the age of 1 year per thousand live births — fall to 9.7, the rate jumped sharply in 2005, to 11.4. The national average in 2003, the last year for which data have been compiled, was 6.9. Smaller rises also occurred in 2005 in Alabama, North Carolina and Tennessee. Louisiana and South Carolina saw rises in 2004 and have not yet reported on 2005. […]

Most striking, here and throughout the country, is the large racial disparity. In Mississippi, infant deaths among blacks rose to 17 per thousand births in 2005 from 14.2 per thousand in 2004, while those among whites rose to 6.6 per thousand from 6.1. (The national average in 2003 was 5.7 for whites and 14.0 for blacks.)

Let me be blunt. This is what people mean when they talk about institutional racism. It doesn’t really surprise me that Mississippi and other southern states have seen this rise in infant mortality primarily among their poor minority populations. Indeed, the problem is a national one as the statistics quoted above indicate. Nonetheless, it’s also clear that these problems are greater in the South, where Republicans and Conservative Democrats take turns controlling the legislatures and governorships. The state governments in the South have consistently lowered taxes and reduced services, especially services to the poorest of their citizens. Since African Americans make up a higher percentage of those who live in poverty in the South, they have borne the brunt of these callous and discriminatory policies.

But state politics and government policies of “malign neglect” did not operate in a vacuum to cause this rapid rise in infant mortality among the South’s poorest citizens. Attitudes and stereotypes toward poor, black women also have had something to do with it:

(cont.)

Another major problem, Dr. Marley said, is that some women arrive in labor having had little or no prenatal care. “I don’t think there’s a lack of providers or facilities,” he said. “Some women just don’t have the get up and go.”

But social workers say that the motivation of poor women is not so simply described, and it can be affected by cuts in social programs and a dearth of transportation as well as low self esteem.

“If you didn’t have a car and had to go 60 miles to see a doctor, would you go very often?” said Ramona Beardain, director of Delta Health Partners. The group runs a federally financed program, Healthy Start, that sends social workers and nurses to counsel pregnant teenagers and new mothers in seven counties of the Delta. “If they’re in school they miss the day; if they’re working they don’t get paid,” Ms. Beardain said.

Poverty has climbed in Mississippi in recent years, and things are tougher in other ways for poor women, with cuts in cash welfare and changes in the medical safety net.

It’s easy to blame the victim. In fact, it’s predictable to see these types of allegations coming from educated, middle and upper class whites, North, South, East or West. But considering that (1) many southern states started from a lower economic baseline than states in other regions, (2) their past history of official segregation and discrimination, and (3) the Republican party, which dominates the region, promotes an agenda of limited government, lower taxation and fewer government services, this was an inevitable result.

In 2004, Gov. Haley Barbour came to office promising not to raise taxes and to cut Medicaid. Face-to-face meetings were required for annual re-enrollment in Medicaid and CHIP, the children’s health insurance program; locations and hours for enrollment changed, and documentation requirements became more stringent.

As a result, the number of non-elderly people, mainly children, covered by the Medicaid and CHIP programs declined by 54,000 in the 2005 and 2006 fiscal years. According to the Mississippi Health Advocacy Program in Jackson, some eligible pregnant women were deterred by the new procedures from enrolling.

One former Medicaid official, Maria Morris, who resigned last year as head of an office that informed the public about eligibility, said that under the Barbour administration, her program was severely curtailed.

“The philosophy was to reduce the rolls and our activities were contrary to that policy,” she said. […]

The state Health Department has cut back its system of clinics, in part because of budget shortfalls and a shortage of nurses. Some clinics that used to be open several days a week are now open once a week and some offer no prenatal care.

The department has also suffered management turmoil and reductions in field staff, problems so severe that the state Legislature recently voted to replace the director.

Oleta Fitzgerald, southern regional director for the Children’s Defense Fund, said: “When you see drops in the welfare rolls, when you see drops in Medicaid and children’s insurance, you see a recipe for disaster. Somebody’s not eating, somebody’s not going to the doctor and unborn children suffer.”

Ironic, isn’t it, that this region which has the greatest number of self-described Christians, and is dominated by evangelical and fundamentalist Christian churches, is the one where infant mortality is rapidly increasing. Unfortunately, the espousal of a “culture of life” has had little, if any, positive effect on either specific government policies or individual attitudes toward the poor, black residents of these states.

But that is the face of white racism today in America. Not often spoken aloud in “mixed” company, and frequently vehemently denied (if intermittently condemned as the case of Don Imus has shown), but definitely still present and very active in shaping the lives of minority populations. Since the largest African American communities still reside in the South, the effects of that racism are most apparent there. But it is a national problem, and a continuing disgrace.

And yes, it is literally killing babies.




























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