Ohio ranks high in infant mortality
When Ohio's abysmal infant mortality ranking - second from the bottom among all 50 states - was publicized several weeks ago, the universal reaction from Columbus outward in every direction seemed to be one of genuine disbelief and dismay.
Ohio is 48th in the nation in overall infant mortality and 49th in the nation among African-Americans.
But what is the picture like in Wood County?
While Ohio's infant mortality rate is 7.7 per 1,000 births for the decade 2000 to 2010, the rate in Wood County is 2.9 for 2010 alone, the most recently reported single year. That represents four deaths out of a total of 1,310 births.
"We stay low, but we fluctuate from year to year," said Ben Batey, R.N., director of nursing services for the Wood County Health District.
Statistics for the last two decades, presented in five-year increments, support his statement.
From 1991-1995 the county's infant mortality rate was 8.2 - worse than the current rate for all of Ohio. It stayed steady at 5.9 from 1996 through 2005, then creeped back upward to 6.2 percent in the most recent five-year reporting period, 2006-2010.
In terms of actual number of deaths, Wood County saw:
• 57 infant deaths from 1991-1995;
• 40 infant deaths - 1996-2000;
• 40 infant deaths - 2001-2005;
• 42 infant deaths - 2006-2010.
These figures are taken from Ohio vital records, compiled at the Ohio Department of Health, Center for Public Health Statistics and Informatics.
"With a low statistic like ours," four deaths last year, "just a couple babies born with congenital issues can really skew your statistics," Batey pointed out.
A breakdown of Wood County's maternal health care data sheds a clearer light on what some of this area's particular problem areas are.
The county percentage of low birth-weight babies - those weighing less than 5 1/2 pounds - was 6.7 percent last year, versus 8.6 percent for the state at large.
The percentage listed as "very low birth-weight" - under 3 pounds, 5 ounces - was 1.0 percent, or 13 babies, versus 1.6 percent for the state overall.
Other revealing categories:
• Pre-term (born before 37 weeks gestation) - 9.9 percent for Wood County, 12.5 percent for Ohio;
• Very pre-term (born before 32 weeks) - 1.8 percent, or 23 babies, for Wood County; 2.4 percent for Ohio;
• Maternal smoking - 12.7 percent of new moms in Wood County, 17.8 percent in Ohio;
• Getting first-trimester prenatal care - 81.6 percent for Wood County, 73 percent for Ohio;
• Unmarried - 30.6 percent for Wood County, 43.7 percent for Ohio;
• Teen birth rate (ages 15-17) - 10 percent for Wood County, 15.7 percent for Ohio.
In general, the ODH reports babies die due to one of five or six main reasons: They are born too small and too early, born with a serious birth defect, are victims of Sudden Infant Death Syndrome (SIDS), are affected by maternal complications of pregnancy, or are victims of injuries such as suffocation.
Local Health District employees currently see low birth weight as "a particular Wood County concern," said Batey.
To combat that problem, "there has been a shift with OB-GYNs to try to get the baby to 40 weeks," or full-term, he said. That means sharply curtailing elective C-sections or pre-scheduling of women's labor at a deliberately early date such as 37 or 38 weeks.
"I think you'll find that figure improving" in the next report, as a result of the county's current infant-mortality prevention efforts, said Pat Snyder, health information and education manager at the Wood County Health District.
In addition to the low birth-weight figures, the maternal smoking rate is also drawing attention on a local level.
"That's one that we really try to focus on here," said Snyder. "We try to screen every single person who comes (to the health department) because that's one of the factors that has really been shown to make a difference."
"We have a nurse here who is a certified Smoking Cessation Specialist, so everyone who comes through here we're working with them to try to reduce that factor that can contribute to infant mortality," Batey added.
Local efforts are made to reduce deaths
The Wood County Health Department currently has several different programs that are directly tied to reducing infant mortality.
Factors known to contribute to infant deaths include:
• family socioeconomic issues;
• people smoking in the baby's home;
• the infant's sleep position, and
• rates of breast-feeding.
"Studies have shown breast-fed babies have lower rates of dying," points out Pat Snyder, the department's health and information manager.
"We have WIC (Women, Infants, and Children food and nutrition service) here in the building, and a big piece of WIC is promoting breast-feeding. We promote that year-round," said Snyder. "We're educating moms when they come in, so that they get not only food assistance but also" they hear a consistent message about the value of breast-feeding.
The county health department has a peer breast-feeding helper right on staff. That's someone who breast-fed her own children. "They can be called at all hours, even in the middle of the night," Snyder added.
The department also has breast pumps which can be loaned out to mothers in need.
Safe sleep promotion involves making sure new parents know that their baby should be sleeping on its back.
Wood County is cooperating with the state's efforts to spread a unified message to decrease SIDS and other sleep-related infant deaths, which account for the majority of infant deaths after the 28th day of life. The message includes:
• Place infant for sleep wholly on the back for every nap time and night time.
• Use a firm sleep surface.
• Room sharing, but not bed sharing with parents, is recommended.
• Keep soft objects, loose bedding, bumper pads and stuffed animals out of the crib.
• Do not smoke during pregnancy and avoid baby's exposure to secondhand smoke.
"Is there any direct proof that a baby died in the home because of smoking?" Ben Batey, health district director of nursing asked rhetorically. "Well, there is definitely (statistical) correlation."
These center around too-young parents, parents of low income, and parents with less than average amount of education.
To address these needs, the department offers prenatal care for any expectant mother in Wood County who doesn't currently have an obstetrician to go to - without regard to her ability to pay.
"We do now take quite a few insurances as well, so even someone who has insurance but doesn't have a doctor they feel comfortable going to, they can come here," Snyder said.
The department works closely with Wood County Women's Care. "They provide us with a nurse-practitioner that comes here to meet with our expectant moms, and then they deliver the babies at Wood County Hospital," thus ensuring continuity of care.
Ohio ranks 49th among the states in infant mortality for African-Americans. But Wood County's racial makeup is quite different from that of Ohio as a whole.
Wood County's population is 89.8 percent white, 4.6 percent Hispanic, and only 2.7 percent black.
The Latino population is the largest minority in the county, and the health department currently has four staff members who are bilingual.
"Ninety-nine percent of the time we have someone here who can translate, and if we don't we have a phone translation service," said Snyder.
Service is also provided to Wood County's migrant population "and that goes back to our mission to serve anyone without regard to ability to pay. We just want to be sure they are getting prenatal care."
Health department nurses regularly visit satellite locations including downtown North Baltimore, Bradner, Northwood, and the Perrysburg Heights Community Center, according to Batey.