High Death Rates For Black Babies In NC: ‘Our Greatest Challenge’

North Carolina holds one of the worst records in the nation for the deaths of children a year old or younger. One big contributor: African-American babies are dying at more than twice the rate of whites. A recent Raleigh News & Observer article, "Urban or rural, black lives in NC are being cut short almost before they begin," explores the reasons why.  

The leading physical causes of death before age 1 are easy to define: preterm birth, low birth weight, congenital deformities, heart defects. Reporter Lynn Bonner says understanding why the gap between black and white infant deaths was wider in 2018 than it was a decade ago is more complicated. 

Bonner has covered the state's high infant mortality rate for years. She spoke with WFDD's David Ford on the role being played by race, and what's being done to narrow the gap.

Interview Highlights

On the logistic challenges faced by expectant African American women in rural areas:

One of the issues is being able to afford to go to the doctor before you get pregnant and early in your pregnancy. African-American mothers are less likely to see the doctor in their first trimester than white pregnant women. It's hard to get specialists in some areas of the state where there are few specialists. Transportation is difficult. 

On equitable treatment by doctors:

I spoke to a number of African American women who talked about being judged for their skin color or their perceived ability to pay. I spoke to one mother who said that for some of her appointments while she was pregnant, she had to take a white friend with her to her doctor's appointments because she was having such trouble getting through to the doctor. 

On the role of stress:

This theory called “weathering” talks about chronic stress and its impact on all kinds of chronic illnesses, heart disease, hypertension and infant mortality among them. The idea is just living with the stress of racism among all classes of African American women contributes to increased infant mortality. 

On what the state is doing to narrow the infant mortality gap:

The gap between black and white infant deaths just fluctuates wildly from year to year and nobody is quite sure why. The data they have on what works and what doesn't work, from what I've been able to gather, is nonexistent. Through the Healthy Beginnings program, they give grants to counties and other nonprofits to run support and education programs for expectant women of color. Women who smoke are encouraged not to. They talk about safe sleep, breastfeeding, and other issues. Whether that is working or not is kind of an unknown. The state is going to begin encouraging a program called Centering Pregnancy which is kind of an education and support group for pregnant women where they learn from each other while they're getting their exams. And there has been some evidence to show that that kind of care improves birth outcomes and leads to healthier babies. So, maybe if that practice becomes more widespread and sanctioned there may be some information there about what helps.

*Editor's note: This transcript was lightly edited for clarity.