By Alander Rocha | Alabama Reflector
Alabama’s infant mortality rate continued a downward trend in 2022 even as infant deaths rose in the nation for the first time in nearly a decade, according to a Centers for Disease Control and Prevention (CDC) report.
But Alabama’s infant mortality rate, which decreased to 6.58 deaths per 1,000 live births in 2022, remains higher than the national average, which increased from 5.44 deaths in 2021 to 5.61. And major racial disparities persist, with Black infant mortality nearly three times higher than white infant mortality.
Dr. Wes Stubblefield, the district medical officer at the Alabama Department of Public Health and a pediatrician, said Friday that the infant mortality improvements have been due to some department programs proving to be effective, though the department is still monitoring the data.
“We have had some improvement, although disparities persist,” he said.
The Fetal and Infant Mortality Review (FIMR) Program is a department initiative to review fetal and infant death cases. It conducts voluntary maternal interviews to improve the health of women, infants, and families. The team reviews case summaries, identifies issues, and recommends community changes. Stubblefield suggested data shows programs could be helping address maternal health disparities.
Ongoing Challenges
While Alabama’s progress is positive, the increase in the national average suggests ongoing challenges.
Compared to Alabama, the CDC report indicates that the overall number of infant deaths in the U.S. rose by 3 percent from 19,928 in 2021 to 20,577 in 2022. The neonatal mortality rate (deaths of infants less than 28 days old) also saw a 3 percent increase, while the postneonatal mortality rate (deaths of infants 28 days to less than one year old) increased by 4 percent.
Racial disparities in infant mortality persist across the country and in Alabama, with Black infants experiencing the highest mortality rate at 10.90 deaths per 1,000 live births in 2022 across the nation, followed by American Indian and Alaska Native infants at 9.06.
In Alabama, the infant mortality rate for Black infants was 12.4 per 1,000 live births in 2022. That’s an increase from 11 deaths per 1,000 in 2018, when numbers started to increase after a drop from 15.3 percent in 2015. For white infants, the mortality rate in 2022 was 4.3 per 1,000, an all-time low.
White infants account for 69.8 percent of births in Alabama but make up 44.5 percent of deaths. Black infants account for 28 percent of births but 51.4 percent of deaths.
The Black Belt
Counties in the Black Belt had some of the highest rates of infant mortality, well above the state average. Perry County’s infant mortality rate was 20.4 deaths per 1,000 live births. Pickens, Sumter, Perry, Conecuh and Butler counties followed respectively, with rates between 15.1 and 15.6 rate of mortality per 1,000 live births.
Many medical centers in the Black Belt don’t have labor and delivery units, forcing many expectant mothers to drive hours to have infants delivered.
Aretha Dix, a rural health care strategist with Lebleu Fields, a wellness consulting firm, said that partnerships between the health care community and rural residents are essential for improving maternal health. Consistent education on overall health, prenatal care and labor practices is needed, she said, along with efforts to overcome barriers to care access and follow-up.
25 counties in Alabama as maternity deserts, lacking obstetrics services or obstetricians available for residents, according to a 2022 report from the March of Dimes. Another 21 counties are classified as places with low access to maternity care.
She said Alabama still has maternity care deserts, particularly in the Black Belt.
“Although there may be medical centers in the Black Belt, they don’t have a prenatal care opportunities or labor and delivery units for expectant mothers,” Dix said. “This means that the expectant mothers have to drive hours to have their infants delivered. Issues that may impact that level of care are lack of resources such as transportation and money.”
She also said that expectant mothers may show up at the ER if they don’t have an established maternal health relationship at that facility, causing issues or delays in the delivery process since providers may not have a full health history on the mother.
