Infant mortality still hits some areas hard

UT study shows ‘false sense of security’ in state

Infant mortality rates in Houston and Texas, thought to be greatly improved in the last 25 years, are still dramatically high in some communities, according to a new study.

The University of Texas System study shows that the state rate, actually lower than the national figure, obscures pockets where alarming numbers of babies are still dying before their first birthday. In some areas, the rates are nearly five times the national average.

“We’ve made progress in Texas as a whole, but the overall rate gives a false sense of security,” said Dr. David Lakey, former Texas health commissioner and current vice chancellor for health affairs at the UT System. “Broken down by ZIP code, it’s clear many

communities are still doing very poorly.”

ZIP codes in Channelview to the east, Acres Homes to the north and north Fort Bend County to the southwest had some of the highest rates.

Lakey said the study shows “one’s ZIP code is as important to their health as their genetic code.”

Infant mortality, a measure of the deaths of infants less than a year of age, is considered a leading health indicator. It provides insight into the health of infants, mothers and the larger community.

Nationally, slightly more than six babies die annually for every 1,000 live births. In Texas, 5.8 of every 1,000 do.

Lakey said he expected there’d be differences in some areas, but nothing like the study found. In some Texas ZIP codes, the study found, more than 10 of every 1,000 babies died before their first birthday. In others, there was not a single infant death in the four-year period studied.

He said poverty and education are part of the problem, but don’t fully explain it.

The study did not look at why such variation exists. Lakey said his team is currently trying to answer that question, but emphasized it was important to make the information available immediately so local health departments and medical institutions can focus their interventions.

“I’m glad someone is doing this sort of uncommon research, diving down to the neighborhood level,” said Dr. Sean Blackwell, chairman of obstetrics, gynecology and reproductive sciences at McGovern Medical School at the University of Texas Health Science Center at Houston. “You can’t improve outcomes unless you know where the infants are dying.” ‘Geographic disparities’

Blackwell said infant mortality remains a big problem in Houston and Texas, overlooked with all the attention given recently to maternal mortality, the death of mothers between childbirth and the first four months after. Houston’s maternal mortality rate is higher than the state rate, which is higher than the national rate, which is higher than the rate in the rest of the developed world. Lakey said the new study, which collected data from 2011 to 2014, shows infant mortality is much more complex than health officials previously thought.

Texas has met national targets for infant mortality since 2012, for instance. Houston has lagged a little behind, but its 6.8 rate for every 1,000 live births represents significant improvement from the 11.5 rate it averaged in the 1980s. Elected city officials at the time called the rate “a moral outrage.”

Despite the overall improvement, the new study shows numerous areas where the rates are well above average. Large swaths of ZIP codes show rates of both 8.2 to 10.95 deaths per 1,000 births and 11 and above. In one ZIP code in Acres Homes, 77026, the rate averaged 28.1.

Infant mortality disproportionately affects blacks — Acres Homes was once considered the South’s largest unincorporated black community — but Lakey noted that race or ethnicity is not the sole explanation for a ZIP code’s high rate. The black infant mortality rate in the more affluent 77077 area in west Houston is 3.3, about eight times lower.

“We tend to think one number represents all for each ethnic group,” said Lakey. “But a clear look at the data shows that geographic disparities are as great as ethnic-based disparities.”

Of the three major racial or ethnic groups, Hispanic women have the lowest rate of infant mortality.

But their infant mortality rates also varied depending on where they lived when they were pregnant, the study found. In some areas of San Antonio, for instance, the Hispanic rate was more than double the national average. Community factor

White women in Texas have a relatively low risk of their baby dying within the first year after birth, but they too fare worse in certain communities, with the highest numbers occurring outside the major metro areas. Longview and Wichita Falls, for instance, both had more than one ZIP code with a white infant mortality more than double the state’s overall rate.

Researchers calculated the rates of ZIP codes with 400 or more births between 2011 and 2014 depending on the mother’s residence at the time of delivery. The data were obtained from the Texas Department of State Health Services.

“Having a lower than average rate, nationally, is not enough when we know that there are communities where rates are tragically high,” said Lakey. “The sooner we can understand why babies are dying, the better off we’ll be.”