By ROSE CONLON
Kansas News Service
WICHITA, Kansas — For years, Black babies in Kansas faced an outsized chance of dying before their first birthday. Then the COVID-19 pandemic hit, and things got even worse.
Now, a Black baby is nearly three and a half times as likely to die in the state as a white baby. While the nationwide rate of infant mortality dropped between 2019 and 2020, the rate in Kansas swelled about 19% — and for Black children, it surged nearly 58%.
That means that for every 1,000 Black children born, nearly 17 died within their first year of life. For white children, the rate is fewer than five out of every 1,000.
“We knew that (the pandemic) was going to impact Black infant mortality,” said Sapphire Garcia-Lies, a Wichita-based doula and the founder of Kansas Birth Justice Society, a nonprofit working to lower racial disparities around maternal and infant health. “But I don’t think any of us knew that it would be that bad.”
Black families run into more barriers in accessing health care before, during and after pregnancy, said Sharla Smith, a professor at the University of Kansas Medical Center who directs the Kansas Birth Equity Network. And the care those families get, she said, is often worse than what white families can expect.
“We see a lot of discrimination,” Smith said. “We’re also hearing from our parents that they’re not listened to.”
She said part of that stems from systemic racism in the health care system, including a dearth of Black and brown doctors.
Questions remain about what’s behind the increase in deaths in 2020. But Smith said that the pandemic’s disproportionate impact on Black communities — including higher rates of infection and death from the virus and job and income loss — likely played a role.
Black people experienced higher rates of COVID-19 and initial studies suggest that infection during pregnancy correlates with a higher risk of preterm birth. Premature birth is one of the leading causes of infant mortality.
In its report on the 2020 data, the Kansas Department of Health and Environment cautioned that a relatively small number of infant deaths, just 224 statewide, means the data can fluctuate year to year without necessarily reflecting a larger trend. Of the 2,369 births of Black babies, 40 died in their first year.
But researchers say such a dramatic jump in Black infant deaths is worrying.
“Yes, we should look at the numbers with some level of caution,” said Cari Schmidt, a professor at KU School of Medicine-Wichita and the director of the Center for Research for Infant Birth and Survival (CRIBS). “But I also think that we shouldn’t ignore the jump — because it could be an indication of the start of a trend.”
Or the continuation of a trend that Smith, the director of the Kansas Birth Equity Network, said has played out in the differences between the health of white and Black children for decades in the state.
“We need to pay attention,” said Smith. “Otherwise we’re never going to decrease these disparities, because we’re always going to say that it’s going to get better on its own — and it doesn’t get better on its own.”
The leading cause of white and Hispanic infant death in Kansas is birth defects. For Black babies, the leading cause is complications related to preterm birth and low birth weight — which experts say is often tied to social and environmental factors.
“Racism is a fundamental factor,” said Dawn Misra, a professor of epidemiology and biostatistics at Michigan State University. “It affects things like segregation of housing, which affects neighborhood environments. It might affect the quality of health care you’re getting.”
She said racism also impacts maternal mental health and parental relationships that can make survival tougher for children. Racism, for instance, can play a role in depression. And depression can be related to premature births.
“Racism does relate to depressive symptoms,” Misra said. “Black men are experiencing a lot of strain in the U.S. as well … and then the (mother-father) relationship may have that stressor added onto it.”
Experts agree that focusing on mothers helps their children.
“You have to have a healthy woman to have a healthy baby,” said Christy Schunn, executive director of the Kansas Infant Death and SIDS Network. “There’s just no two ways around it.”
Kansas made a limited expansion of Medicaid for mothers for up to 12 months after giving birth. Previously, coverage ended after two months.
Meanwhile, grassroots initiatives like a free doula program offered by the Kansas Birth Justice Society hope to make a difference. Parenting classes offered in Black churches by CRIBS and the Wichita Black Nurses Association also aim to give infants a better start.
But CRIBS director Schmidt said there’s a long way to go.
“We need to have healthy families, healthy relationships, healthy persons prior to the pregnancy,” she said. “And we need to address those social determinants of health such as poverty.”
Rose Conlon reports on health for KMUW and the Kansas News Service. You can follow her on Twitter at @rosebconlon or email her at [email protected].