Detroit’s infant mortality rate made a historic drop. Here’s why from The Detroit News
May 7, 2021
Detroit’s infant mortality rate — once highest in the nation, exceeding many Third World countries — achieved a historic drop in 2019, helping Michigan achieve its lowest infant mortality rate in more than 100 years, according to state health officials.
The dramatic decrease was announced amid fanfare Wednesday by Detroit Mayor Mike Duggan and Michigan’s Chief Medical Executive Dr. Joneigh Khaldun, who served as director of the Detroit Health Department from 2017 to 2019.
The city’s infant mortality rate dropped more than a third from 16.7 infant deaths per 1,000 live births in 2018 to 11 infant deaths per 1,000 live births in 2019, according to the Michigan Department of Health and Human Services.
The rate of 11 deaths was the city’s lowest rate going back at least to 1990, according to state data. During the 29-year period, Detroit hit a peak rate of 21.4 deaths per 1,000 live births in 1992.
Statewide, Michigan’s 2019 infant mortality rate of 6.4 infant deaths per 1,000 live births was the lowest in recorded history. And the gap between Black and White infant mortality reduced from a disparity ratio of 3.2 in 2018 to 2.6 in 2019, according to state officials.
“That’s the lowest rate the state has seen in more than 100 years,” said Khaldun Wednesday, adding that as an emergency physician, it was hard not to get emotional about the improvements.
“I’m an ER doc. I have pronounced infants dead before,” she said.
City officials also noted, according to state health department data, that Detroit closed the disparity gap between Black and White babies dying before their first birthdays. While Black babies saw a drop from 18.9 deaths per 1,000 live births in 2018 to 12.3 in 2019, White babies experienced an increase from 6.4 to 9.7 during that timeframe.
The overall infant mortality decline is a stark contrast from 2014 when a Detroit News investigation revealed the city had the highest child death rate in the nation in the series “Surviving through age 18 in Detroit” due to the combined effects of having the nation’s highest rates of child homicide and infant mortality.
The News’ report was based on data from 2010, then the most recent year for city-level data from the U.S. Census Bureau. Detroit’s infant mortality rate at 13.5 infant deaths per 1,000 live births was worst in the nation.
By 2014, Detroit’s rate decreased to 10.5 infant deaths per 1,000 live births, with Cleveland having the worst rate at 11.3 deaths per 1,000 babies born alive, according to information from the Anne E. Casey Foundation’s Kids Count Data Center. The foundation appears to use different data than the state of Michigan.
Detroit and Cleveland have since jockeyed to avoid worst place, with Detroit having the highest number of infant deaths per thousand in 2016 and 2017, and the Ohio city reporting the most in 2014, 2015 and 2018, according to Kids Count data.
‘Everybody working together’
Duggan credited the improvement to initiatives implemented under Khaldun’s leadership, such as providing free Lyft rides to prenatal appointments and starting a “Sister-Friend” program that matches new pregnant moms with more experienced mothers for support.
“Look what happened in 2019: We saw 55 more babies were alive at the end of the year,” said Duggan, the former CEO at the Detroit Medical Center. “This is what happens when you have the public health department and you have a strategy.”
The improvement couldn’t have happened without the combined efforts of hospitals and organizations across the city that finally came to fruition, the mayor said.
A variety of state, city and private efforts are responsible for the infant mortality decline, said Alex Rossman, spokesman for the Michigan League for Public Policy’s Kids Count in Michigan Project.
The state health department’s Mother Infant Health & Equity Improvement Plan and the Whitmer administration’s Healthy Moms, Health Babies initiative “improved prenatal and postpartum care for expectant mothers” through Medicaid, he said.
Rossman acknowledged the city of Detroit’s “multiple outreach and information campaigns targeting expectant mothers.”
Duggan noted programs, such as Make Your Date, a collaboration between the city and Wayne State University that has been surrounded by controversy, and prenatal programs run by Henry Ford Health Center and Ascension St. John Hospital as well as community organizations such as the Black Mothers Breast Feeding Association.
“This is how we do it, everybody working together,” Duggan said.
Detroit improved by one place in the Kids Count rankings for 2019, moving ahead of both Memphis, Tenn., and Cleveland, which had the high infant deaths in the country.
Though Detroit’s data has improved, the city’s rate of 11 infant deaths per 1,000 live births tied with such countries as Mexico, Ecuador and Uzbekistan — and remained close to those of Libya and North Korea, which both have infant mortality rates of 12 infant deaths per 1,000 live births.
“It is heartening to see the infant mortality rate continue to improve in Michigan and specifically in Detroit,” Michigan Kids Count’s Rossman said. “We have seen marked improvement in infant mortality over the past decade, and that’s due in part to a concerted, intentional effort to improve birth outcomes for Michigan and Detroit mothers, especially Black mothers and babies.”
Wayne State University’s Dr. Sonia Hassan, associate vice president of the Office of Women’s Health, credits Make Your Date’s provision of free Lyft rides to prenatal appointments and other services with contributing to Detroit’s decline in infant deaths.
Defining infant mortality
Infant mortality is considered the death of an infant before reaching the age of 1. Causes of infant mortality included birth defects, preterm or premature birth, maternal pregnancy complications, Sudden Infant Death Syndrome and injuries like suffocation.
The greatest cause of infant mortality is premature birth, said Dr. Sonia Hassan, a professor of obstetrics and gynecology and maternal-fetal medicine who co-founded Wayne State University’s Make Your Date program with Duggan in 2014.
Make Your Date seeks to help women avoid premature delivery and give birth to their babies at full term.
“It’s amazing and great news,” said Hassan of Detroit’s reduction in infant mortality. “The reduction was for 2018 to 2019, but for years before that, there was a real big focus in the city by many groups on infant mortality — and it really made a difference.
“Our program had high volume enrollment and others did too during that time. We were able to partner with the city on the transportation piece. So we were able to get a lot of people to services that they needed.”
Make Your Date, Henry Ford Health System, Ascension Health, the March of Dimes and numerous other partners focused on moving the needle, she said.
“All of those people collectively as a group really were focused on infant mortality,” she said.
Make Your Date has come under scrutiny from Detroit’s inspector general and Michigan Attorney General Dana Nessel’s office, which reviewed allegations that public funds were misappropriated and emails destroyed “to hide a personal relationship between the mayor of Detroit and the director of the Make Your Date Program.” But Nessel said last month that “the facts and evidence in this case simply did not substantiate criminal activity, and therefore we cannot pursue charges against any individuals.”
The city’s inspector general released a scathing report in 2019 that found Duggan “unilaterally” directed city resources toward assisting a nonprofit, and his chief of staff and other top aides abused their authority by directing staff to delete emails detailing those efforts, undermining “the public’s trust in an open and transparent government.”
Duggan and Hassan have declined to discuss their personal lives, but the mayor’s wife, Mary Loretto Maher, filed for divorce in May 2019.
Detroiter Samitrah Ringo’s son, Skylar, was born five weeks prematurely in 2009, but she was able to get medication from the Make Your Date program that helped her two other children — son Amir, 5, and daughter MyLynn, 1 — make it to full term.
Women enrolled in Make Your Date receive an ultrasound to determine if they have a condition called short cervix that can cause preterm birth. The condition can be treated with progesterone, which Ringo, 28, received.
“They provided me with more information and options throughout my pregnancy,” Ringo said. “They started providing Lyft rides, which I needed because I was very sick (with morning sickness) throughout my pregnancy.
“I was given a progesterone shot every other week, and it worked.”
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