Preliminary data shows decrease to infant mortality. Expert says rate is consistent but concerning

Preliminary data for 2023 shows a decrease in Indiana’s infant mortality rate for the first time since 2019, according to a new report.

The preliminary data from the Indiana Department of Health shows the state’s infant mortality rate dropped to 6.5 deaths for every 1,000 live births in 2023. That’s down 0.7 from the previous year.

Angela Campbell, an assistant professor of applied health science at Indiana University Bloomington, said the rate fluctuates from year to year, but consistently remains too high.

“We should definitely be thinking about this and trying to improve things, but it's not clear that we are definitely moving in one direction or another,” Campbell said.

The report also shows Black infants in Indiana continue to die at higher rates than any other demographic group. It confirmed that the 2022 mortality rate for Black infants was 14.1 deaths for every one thousand live births. That’s compared to the rate of 7.9 for Hispanic infants and the rate of 5.6 for White infants.

Campbell said a variety of factors play into that racial disparity, including barriers to vital resources.

“It's easy to sort of look at these numbers and be like, ‘Oh, well, Black women must be doing something wrong,’ but that's absolutely not what's happening,” Campbell said.

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In addition to social factors, such as inadequate housing and barriers to accessing healthcare, Campbell said one of the biggest contributors to perinatal risk for Black individuals is preterm birth, which occurs before 37 weeks.

While there are multiple reasons an infant is born early, one reason is a complication called preeclampsia, which affects Black pregnant people at a much higher rate.

“They have to deliver the infant in order to save the mother's life,” Campbell said. “It's also not good for the infant to be in those high stress kinds of situations. It's always a trade off between trying to keep the infant in the womb as long as possible while also trying to protect [the pregnant person’s] health.”

Campbell said perinatal care can help identify those risk factors.

The report found that about 29 percent of 2022 births were to people not receiving prenatal care during the first trimester, which is considered a statistically significant increase compared to 2021.

Tara Morris, Executive Director of the Minority Health Coalition in Elkhart County, said the first trimester is a very important time to connect a pregnant person with a doctor.

“It takes building communication that closes that gap,” Morris said. “Connecting and dialoguing with these moms in order for us to get the best outcomes that we can, so providing intervention earlier in the pregnancy is going to be crucial.”

In addition to limited prenatal care, the report identified three other factors contributing to the high infant mortality rate: obesity, smoking and unsafe sleep practices. But those factors can be complicated to address.

Campbell said it’s difficult to address issues with weight once someone is pregnant. She also said people may engage in unsafe sleep practices because they don’t have the space or money for something like a bassinet. In addition, Campbell said some parents may not know that babies shouldn’t have anything else with them while they are sleeping, such as a blanket or a toy.

Morris’ organization has been working to connect parents to vital resources like perinatal care or doulas. She said infant mortality has been an issue in Indiana for a while, and people on the ground need more support from the state.

“We need more dollars,” Morris said. “We need more assistance. We need more manpower to get this work done.”

Morris said advocates have been doing what they can, but this issue needs to be addressed more on the statewide level.

Abigail is our health reporter. Contact them at aruhman@wboi.org.