A community forum, Strengthening the Health of Detroit’s Mothers and Children, is taking shape to examine the causes of high rates of infant mortality. Let’s hope the results will be more than illuminating. No health issue is more misunderstood, misinterpreted and without imminent solution.
Despite major advances in medical technology, infant mortality threatens to unravel the very fabric of life in urban America. This medical malady, after all, leaves its most discernible mark among the black population.
For years, public health officials have grappled with its staggering consequences, the origins of which are many and deeply rooted. Debates about where to attach responsibility range from a lack of improper prenatal care, to poor nutrition and whether teens having babies is a cause or consequence of poverty. The magnitude of the problem, however, rejects any one narrow diagnosis.
Economics may play a role in the difference between black and white infant mortality rates, but probably not to the extent social scientists would have us believe. After all, studies show that even among college educated, middle-class mothers, black infants have nearly twice the mortality rates of comparable white infants.
One indisputable contributor is that babies born to teenage mothers are most at risk. More than half of black babies today are born to a single mother who is socially, economically and psychologically ill equipped for motherhood. These mothers are apt to develop serious, nutritionally related medical problems because they are poorly prepared for understanding the biology of reproduction.
Also contributing to a complicated continuum of trends is the underutilization of existing prenatal services. Health providers often have no way of reaching thousands of young mothers who may never see a doctor before delivery. The result is often low birth weight babies that are born with long-term and often fatal disabilities that result from their fragile condition.
This tragic dilemma may be immune to socially engineered, government-financed remedies when we consider the devastating consequences of crack and heroin on black families and communities.
Drug-addicted babies, exposed to drugs while in the womb, made their way onto the social agenda in the 1980s. Studies show babies born to heroin and cocaine users are four times more likely to be born premature. Many require extensive, intensive care. Low birth weight infants are 20 times more likely to die the first year of life than babies born at normal weights. Those that survive the neonatal period face a future of uncertainties and lifelong disabilities such as autism, retardation, cerebral palsy, vision and hearing impairments, and learning disabilities. Typically irritable and extremely difficult to nurture, they need special medical care, as developmental problems may not surface until age two or three.
The surge in drug use, smoking and alcohol use among the young will only add to this already depressing morbidity and mortality forecast. Personal values, sexual practices, cultural attitudes, low self-esteem and indifference are intricately woven into the complexities of infant deaths.
More distressing than the plight of these children is that this well-documented problem still lacks, a well-defined solution. Infusions of taxpayer dollars and creative state and local health programs have done little to take Detroit out of the running for the national leader in infant mortality and morbidity.
Our failure to save defenseless babies from preventable death and sickness is a manifestation of our inability to come to terms with a more ominous cultural disease. The force pushing easy solutions beyond our reach is the social breakdown that occurred in the city. Reversing that trend requires long-term behavior modification. Detroit’s unborn and newborn don’t have that much time.