Q: Who or what is killing so many infants in Oklahoma?

Oklahoma has one of the highest infant mortality rates in the country, ranking 8th worst among states and the District of Columbia in 2010.

That fact is viewed as alarming not only because too many babies die, but because infant mortality is considered the key measure of a state’s or nation’s overall wellbeing. It is the telltale convergence of health indicators.

In Oklahoma, for every 1,000 live births, 7.59 babies died before their first birthday in 2010, according to the National Center for Health Statistics. The rate is especially high for African-American babies, at 12.38.

Like the nation, Oklahoma has seen its infant-death rates fall significantly over many decades, with some ups and downs. Reasons range from more intervention and better nutrition to advances in medicine, health care access and education. Oklahoma, however, has posted a higher rate than the U.S. every year over the past two decades, according to the Oklahoma Department of Health.

The main causes of infant death in Oklahoma are, in order, congenital defects, disorders related to premature births and low birth weights, and Sudden Infant Death Syndrome. For African-American babies, the leading cause is disorders related to premature and low-weight births, followed by congenital defects and pregnancy complications due to the mother’s health, such as high blood pressure.

Behind these causes are both behavioral and systemic issues.

Smoking can be a factor in premature births or low-birth weights, said Janette Cline, maternal and child health counselor for the health department. Secondhand smoke plays a role in causing SIDS.

About 19 percent of Oklahoma’s mothers smoke during pregnancy, according to a state health department report. Obesity and poor overall health can lead to pregnancy complications such as premature birth, Cline said.

Oklahoma also has problems with access to care, which means mothers may lack insurance or live far from hospitals with adequate baby-delivery equipment or far from providers that take SoonerCare, which is Oklahoma’s Medicaid program, Cline said.

As to why African-African babies die at higher rates and for somewhat different reasons, Cline said it could be socioeconomic factors, such as lack of insurance, poor access to healthy food and limited physical activity due to a lack of safety in the community. Cline added that while these may contribute to that group’s higher infant-mortality rates, socioeconomic factors aren’t limited to the Black community.

To combat infant deaths, the health department started an initiative in 2009 called “Preparing for a Lifetime, It’s Everyone’s Responsibility.” It seeks to provide mothers with information on healthy pregnancies and pushes hospitals and other providers to give proper care, such as trying to get more women to have 40-week, full-term pregnancies. The initiative also teaches mothers about healthful living before, during and between pregnancies and encourages them to quit smoking during and after pregnancy.

“It’s a challenge to make change on a statewide level, so we are going at in multiple ways,” Cline said. “[Infant mortality is] huge. It’s a big issue we should address.”

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