Local health officials are continuing their efforts to reduce the number of Bartholomew County infants who die before their first birthday.

The infant mortality rate in Bartholomew County from 2018 to 2022 was 7 deaths per 1,000 live births, up slightly from 6.8 from 2017 to 2021 and 6.5 from 2016 to 2020, according to the most recent county-level data available from Columbus Regional Health and the Indiana Department of Health.

By comparison, Indiana’s rate was 6.8 over from 2018 to 2022. The U.S. rate hovered between 5.4 and 5.7 each year over that period, according to final and provisional data from Centers for Disease Control and Prevention.

The infant mortality rate is the ratio of infant deaths per 1,000 live births. For the purposes of calculating the rate, an infant is defined as a baby less than 1 year of age. Researchers and policymakers often consider the infant mortality rate to be a barometer of the overall health of a community.

Because there are fewer than 20 infant deaths in Bartholomew County per year, health officials opt to calculate the local rate in five-year intervals. The Indiana Department of Health says that rates based on fewer than 20 deaths can be unstable and “should be interpreted with caution.”

While the infant mortality rate has ticked up, it remains lower than from 2015 to 2019, when the rate was 7.7, and considerably lower than from 2011 to 2015, when the rate was 10.7.

“Overall, we’re still trending down from where we were,” said Patty Pigman, an infant mortality prevention specialist at Healthy Communities. “We’re not seeing these huge peaks like (before). …We’re starting to level off a bit.”

Seven Bartholomew County infants died before their first birthday in 2022, Pigman said. Preliminary 2023 figures show that five local infants died, though that number could be revised later. By comparison, 15 Bartholomew County infants died in 2015, as well as 12 deaths in 2019.

However, not all of those deaths may have occurred in Bartholomew County, as the Indiana Department of Health records infant deaths by the county in which the infant resided at the time of death, which is not necessarily the county in which the infant died.

Records from the Bartholomew County Health Department, which only tracks deaths that occur within the geographical boundaries of the county regardless of the infant’s county of residence, show that three infants died within the county lines in 2023.

The causes of death were listed as pulmonary hypoplasia, sudden unexpected infant death and probable asphyxia in the setting of unsafe sleep, according to county records. Pulmonary hypoplasia is a medical condition characterized by underdeveloped lungs that can affect breathing, heart function, ability to feed, hearing and overall development, according to the Children’s Hospital of Philadelphia.

Local officials have described infant mortality as a “complicated issue” and say that it is hard to pinpoint all the factors that may have led to the general decline in the infant mortality rate in Bartholomew County but believe that “better and early” access to prenatal care could be playing a role.

“I think we’re seeing better and earlier entry into prenatal care across the county,” Pigman said. “I think that we’re doing a good job of getting folks into that. …I’d like to say, ‘We did all this stuff, and it got better,’ but I don’t necessarily know that. We’re still seeing deaths.”

At the same time, officials are continuing their efforts to educate parents and other adults in the baby’s life such as grandparents on a range of topics, including safe sleep practices and making sure every family has what they need to practice safe sleep.

Additionally, a class that offers a space for fathers “to ask questions without mom,” called Daddy 101, has been “pretty popular” over the past year or so, Pigman said. Local officials also have produced a podcast called the IMPACT Healthy Communities Podcast that includes interviews with experts in the medical field.

Healthy Communities’ Infant Mortality Prevention Action Team is currently working on building a new support group for pregnant women and mothers that includes a wellness group at NexusPark. The team also expanded into Jennings County last year.

The update from local officials comes after the Indiana Department of Health reported that the state’s infant mortality rate increased from 6.7 in 2021 to 7.2 in 2022. State health officials also reported a preliminary 2023 statewide infant mortality rate of 6.5, though officials said that figure is subject to change.

Indiana’s infant mortality rate continues to be higher than most other states. In 2022, Indiana had the seventh highest infant mortality rate in the country, according to provisional figures released this past November by the Centers for Disease Control and Prevention’s National Center for Health Statistics. By comparison, Massachusetts’ infant mortality rate in 2022 was 3.3, the lowest in the nation.

The Indiana Department of Health said the greatest contributing factor to infant deaths in 2022 was perinatal risks or conditions related to the health and well-being of the mother. Perinatal risks include conditions that originate during pregnancy, during the birth process or very shortly following birth that affect an infant.

Other factors included lack of early prenatal care, stress, obesity and smoking. Nearly 36% of Indiana women who gave birth in 2022 were obese, while another 26% were overweight, according to the Indiana Department of Health.

Locally, officials remain optimistic that the infant mortality rate will continue its downward trend. However, it may be a couple years before that is reflected in the statistics, as there is a lag time with the data.

“We really started hitting the ground running in 2019 but didn’t get a lot of our interventions up until 2020,” Pigman said. “So, 2020 through 2024 will be a good five-year period where we’ve actually been intervening on this work.”

At the same time, zero infant deaths “is not attainable,” she said.

“It’s such a complicated issue,” Pigman said, “It’s really hard sometimes to even look at a single case and say, ‘That’s exactly what happened.’ And even if we can figure out exactly why something happened, it has been very hard to figure out how to prevent that sometimes.”
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