A significant decline in the number African American infant deaths in 2018 contributed to Forsyth County having a lower overall rate of infant deaths for the first time in three years, according to data released this week by the N.C. Center for Health Statistics.

The rate measures mortality for children younger than age 1. In 2018, there were 36 infant deaths in Forsyth — 15 African Americans, 15 whites and six Hispanics — for an overall rate of 8.3 for every 1,000 live births.

By comparison, there were 43 deaths in 2017, 42 in 2016, 31 in 2015 and 29 in 2014.

Still, black infants continue to die at a higher rate than white and Hispanic infants.

The 2018 breakdown for blacks was 12 deaths per 1,000, whites at 7.3 per 1,000 and Hispanics at 6.9 per 1,000.

For 2017, there were: 25 blacks for a rate of 19.3 deaths per 1,000; nine whites for a rate of 4.5 per 1,000; eight Hispanics for a rate of 8.7 per 1,000; and one in the “other” category for a rate of 7 per 1,000.

Forsyth’s 2018 reduction in black infant deaths places it at the state rate of 12.2 per 1,000, while the white and Hispanic rates are above the state rate of 5 and 4.8 per 1,000, respectively.

The 2014 total is the lowest level for Forsyth since the center began tracking data in 1994. Forsyth’s highest infant mortality rate was 14.7 in 1997.

Mayor Allen Joines said that “reducing infant mortality rates is one of the key objectives of our community, and a lot of different agencies are working on the issue.

“It is encouraging to see the numbers again move in the right direction.”

For the state’s five metro counties, Guilford County had 52 deaths with an 8.5 rate per 1,000 live births. Durham County had 23 deaths (5.5 per 1,000), Mecklenburg County at 75 (5.3 per 1,000) and Wake County at 67 (5.3 per 1,000).

“In general, we focus on the average over a 4-5 year time frame versus one single year since the number and deaths can vary from year to year,” said Joshua Swift, Forsyth’s health director.

There were 181 deaths in Forsyth from 2014 to 2018, or 8.2 per 1,000. During that time period, Guilford had 259 deaths, or 8.4 per 1,000, while Durham had 135, or 6.3 per 1,000, Mecklenburg had 432, or 5.9 per 1,000, and Wake had 342, or 5.4 per 1,000.

“I believe we are seeing some small progress in Forsyth County,” Swift said.

“To continue to reduce infant mortality, we must support moms before pregnancy, during pregnancy and after the birth of their child.

North Carolina had 806 infant deaths in 2018, or 6.8 deaths for every 1,000 live births. That was down from 852 deaths, or 7.1 per 1,000, in 2017.

Both the 2018 percent decline and the total number of infant deaths represent record lows for North Carolina

“These numbers are encouraging, but there is more work to do,” Gov. Roy Cooper said in a statement. “Reducing infant mortality remains the first goal in our North Carolina Early Childhood Action Plan.”

No single factor

Forsyth and state health officials have said that “there often is no single factor that causes the death of an infant. It is often the result of a number of contributing factors.”

Leading causes are preterm birth and low birth weight, birth defects, Sudden Unexpected Infant Death, maternal complications of pregnancy, labor, and delivery, and other conditions around the time of birth.

“We have to continue to focus on prenatal care, newborn screenings and safe sleep, while expanding our efforts to look as a community at issues around food insecurity, jobs, interpersonal violence, and housing, which affect the health of the community,” Swift said.

Statewide, congenital malformations joined the joint category of prematurity and low birth weight as the leading causes of death for infants. Both causes contributed to 140 deaths, or 17.4% each.

The category of “other ill-defined and unknown causes of death” was third at 116, or 14.4%. Other conditions originating in the perinatal period was fourth at 11.5%, or 93 deaths. Maternal complications in pregnancy, labor and delivery was fifth at 10.4%, or 84.

Just three infants died from sudden infant death syndrome, compared with nine in 2017, 13 in 2016, 28 in 2014 and 23 in 2013.

“Infant health is an indicator of societal health, and reducing it requires a continued comprehensive effort,” Dr. Mandy Cohen, the state’s health secretary, said in a statement.

Local efforts

The Forsyth health department and Forsyth Infant Mortality Reduction Coalition are focusing on reducing pre-term birth, supporting and improving mental-health services for women and stressing the importance of women and men of reproductive ages to develop reproductive life plans.

The Kate B. Reynolds Charitable Trust and Novant Health Inc. launched Forsyth Connects in May 2016. The initiative provides free in-home nurse visits to all mothers with newborn babies who are born and live in Forsyth. The baby doesn’t have to be the mother’s first.

The Forsyth Connects team visits with families two to four weeks after birth. Depending on the family’s unique needs, a registered nurse may visit one to three times during the baby’s first three months.

Dr. Phillip Heine, chair of obstetrics and gynecology at Wake Forest Baptist Health, said local communities are benefiting from statewide pregnancy medical home programs “that bring together leaders from all regions of the state to target maternal health issues that affect infant mortality.”

“This program, sponsored by DHHS, has initiatives that address how we approach patients who are at risk for preterm birth, along with smoking cessation and appropriate postpartum and inter-conception care provided to mothers between pregnancies to improve health outcomes for women, newborns and children.”

Source: N.C. State Center for Health Statistics, Vital Statistics Death Certificate data

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