More American babies died before their first birthday last year than in the past twenty years. Most of them were Black. Black infants and their mothers have the highest mortality rate in the United States. Over the past century infant mortality has been decreasing, with more newborns surviving every year until 2022, when that trend was reversed, according to Danielle M. Ely, a health statistician with the National Center for Health Statistics. These losses occur even in communities that otherwise appear to have vast health resources. Harris County ranks third, behind only Chicago’s Cook County and Detroit’s Wayne County, in what are known as excess Black infant deaths, according to the federal Health Resources and Services Administration.
“This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who’s disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.
Houston is home to two public hospitals and the Texas Medical Center, the largest medical complex in the world, but mortality rates were 11.1 per 1,000 births for Black infants from 2014 through 2019, according to the March of Dimes, compared with 4.7 for white infants. Even this abundance of providers in Harris County has not made it easy for pregnant Black patients to get culturally competent care that acknowledges an individual’s heritage, beliefs, and values during treatment.
In fact, Texas had the lowest percentage of mothers receiving early prenatal care in the nation in 2020, according to the 2021 Healthy Texas Mothers and Babies Databook with Black moms and babies being less likely to receive first-trimester care than any other racial and ethnic group. Babies born without prenatal care were three times as likely to have a low birth weight and five times as likely to die as those whose mothers had adequate and timely care. Pregnancy complications are now more prevalent than ever, as more women (but especially Black women) begin their pregnancies with underlying medical conditions like high blood pressure, obesity and diabetes. This makes Blacks three times more likely to die in or immediately after childbirth according to Roni Caryn Rabin of The New York Times (https:// www.nytimes. com/2023/11/01/ health/infantmortality-raterise.html).