According to a report released Wednesday by the nonprofit Tennessee Justice Center, an average of 7.4 out of 1,000 infants in Tennessee die before reaching their first birthday. Nationwide, the infant mortality rate is 5.8 deaths out of 1,000 live births.
“We wanted to highlight this issue particularly since September was National Infant Mortality Awareness Month,” Kinika Young, director of children’s health at the Tennessee Justice Center, said.
“We also wanted to draw attention to some of the likely culprits for these high rates and some potential solutions, including some things currently going on, as well as some opportunities that Tennessee could take advantage of to address the contributing factors and improve health outcomes for children and pregnant women.”
Based on the latest Child Fatality Annual Report, Washington County had a 7.5-out-of-1,000 infant mortality rate, while Carter County experienced an 11.3 infant mortality rate. Unicoi County and Sullivan County both had rates below 6.5 per 1,000 live births.
The report attributes Tennessee’s considerably high rate to several factors, including obesity, substance abuse and smoking while pregnant.
“This reveals a deeper problem rooted in the health and quality of life of our state’s mothers — the heightened rates of mothers who smoke, have poor health, and struggle with substance abuse can help explain the high rates of premature and low-birth-weight babies in Tennessee,” the report stated.
An abnormally high rate of premature births was also mentioned as a contributing factor to infant deaths. Approximately 11.3 percent of all births in Tennessee were considered premature in 2016, and premature births accounted for 26 percent of the state’s reviewed infant deaths, Tennessee Justice Center researchers determined.
Tennessee Department of Health data shows an average of 14.9 percent of pregnant mothers smoke in Tennessee, while several Tennessee counties had shockingly high rates that exceeded 27.1 percent.
“This is a huge issue, as approximately 29 percent of Tennessee infant deaths in 2015 were linked to mothers who smoked while pregnant. Intrauterine smoke exposure can deprive a developing fetus of food and oxygen, lead to miscarriage, increase chances of a premature birth and low birth weight, lead to birth defects, and put an infant at greater risk of SIDS (sudden infant death syndrome),” the report stated.
The high incidence of neonatal abstinence syndrome, or NAS, in Tennessee and especially Northeast Tennessee, was also linked to the high infant mortality rate. NAS is withdrawal symptoms experienced by babies born to mothers addicted to opioids during pregnancy.
“NAS is especially rampant in East Tennessee, where some counties are experiencing NAS rates that are eight times higher than the national average — the national average is approximately 6 cases of NAS per 1,000 live births, and Sullivan County reported 50.5 cases per 1,000 live births,” the report states.
The researchers conclude the best way to address the high rates is through the implementation of early and consistent prenatal care for women.
Some of the programs and initiatives already instituted include: Staffing health departments with Certified Application Counselors to assist eligible pregnant women; the Tobacco QuitLine; the Department of Health’s “ABC’s of Safe Sleep” campaign; and the Prevent Child Abuse home-visit program.
The most notable recommendation to improve infant health is through the expansion of Medicaid in Tennessee.
“Women would have better prenatal health and continuity of care if they had access to health insurance before they got pregnant. Medicaid expansion is a cost-effective solution for better pre-conception health and therefore healthier mothers and babies. Additionally, Medicaid expansion would bring an influx of federal dollars (an estimated $1.4 billion annually) that could help struggling hospitals, particularly in rural Tennessee where mothers are in worse health,” the report states.