"Ask the Doctor:" What Is Infant Mortality Awareness Month?
Dr. Torian Easterling, Assistant Commissioner
Brooklyn District Public Health Office
The Center for Health Equity
NYC Department of Health and Mental Hygiene
Infant mortality is the death of a baby before his or her first birthday, and September is the month when we give special attention to preventing these deaths about how to prevent these deaths. The sad reality is that we have not found a way to protect all babies born in New York City. Despite an all-time low infant mortality rate, major racial and ethnic disparities persist among Black and Latino/Latina babies born in NYC.
We see these disparities in the infant mortality rate: the number of children who die in the first year of life out of 1,000 babies born in the same population. In NYC, the infant mortality rate among Black infants is almost three times higher than the rate among White infants. These persistent disparities are a direct result of the social, economic and health inequities that low-income communities of color face. It is clear that we have not done all we can for all babies born in NYC when disparities such as these exist. We need to do better.
According to the NYC Department of Health, the three leading causes of infant death in New York City are prematurity, birth defects, and cardiovascular diseases. External causes, including injuries and homicides, also cause a large percentage of infant deaths. This is a trend we will not let go unaddressed.
To protect the youngest and most vulnerable New Yorkers, it is important that we provide opportunities for women and men to achieve their healthiest state. Preconception health refers to the health status of women and men during their reproductive years. Practicing healthy behaviors prior to becoming pregnant or fathering a child ensures the greatest chance for a healthy start to a baby's life. Adopting healthy eating habits, engaging in physical activity, getting regular health care, and managing chronic conditions like high blood pressure and diabetes are important. However, communities of color and low-income neighborhoods have been systematically deprived of many of the necessary resources to ensure the best health. We must work together to make healthier choices easier choices in our communities.
We are making progress. We are increasing access to bike lanes in Brownsville. We are advocating for affordable housing for families in East New York. In collaboration with local community partners, we are providing technical assistance to local farmers' markets. We are also providing Health Bucks, $2 dollar coupons that can be redeemed at a local farmers' market after spending $5 on produce — promoting good nutrition. Collectively, we can make a difference in our neighborhoods, "right" the injustice that is health inequity, and build up our communities to support health at all stages of life.
In regards to infant mortality, pregnancy and the months after birth are of course the most crucial time of development for a child. They're important for the mother too, though: A woman's body goes through many changes during pregnancy, especially during the first trimester, and pregnancy-related deaths often result from chronic conditions, poor access to health care and other social issues. That is why my office is committed to providing place-based maternal and child health programs.
The Center for Health Equity's Healthy Start Brooklyn program provides support for pregnant women and their families with home visiting, doula support and classes in childbirth education, prenatal and postpartum exercise, parenting, and infant safety. Following the birth of a child, home-based programming, such as the Newborn Home Visiting Program, provides education and referrals to additional services a mother may need within the home. In addition to supporting mothers, home visits also engage fathers on how to serve as better advocates and supportive partners.
We are also championing the first food — breast milk, a cornerstone for the early health and development of infants. The Center for Health Equity's Brooklyn Breastfeeding Empowerment Zone is a place-based initiative to increase community awareness and support around breastfeeding, with the aim of addressing the large racial disparities in breastfeeding rates.
Finally, we must also ensure that families feel supported to have another child if it is their wish. Interconception care is the care a mother receives between pregnancies. As such, we need to promote health throughout the life course. In our clinical settings, education and information about contraception choice should be discussed. We need to continue to engage fathers on how to best support their partner and their child's health. And of course, we must ensure that families have adequate access to medical and social services.
Parenting is a bountifully rewarding experience, and while our communities face a number of challenges in starting on the right track, together we will work to support them.
