Politics & Government

Infant survival improved in North Carolina, but black babies are more likely to die

Babies born in North Carolina were more likely to live to see their first birthdays last year, but black infants were still more than twice as likely to die in infancy than white infants, according to the new 2018 North Carolina Infant Mortality Report.

Gov. Roy Cooper’s office released the report Monday, saying the state has a record low death rate for infants in the state in the last 30 years. The death rate for children younger than a year old dropped to 6.8 for every 1,000 births last year, from 7.1 for every 1,000 in 2017.

“These numbers are encouraging but there is more work to do,” Cooper said in the release.

Keeping more infants alive is a top priority for the state Department of Health and Human Services, which has an emphasis on reducing the gap between black and white survival rates. A goal in the state’s Early Childhood Action Plan is to reduce the ratio to 1.92 by the year 2025. The ratio was 2.44 last year.


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A separate plan to improve infant and parent health includes a dozen goals that range from providing healthcare for women between pregnancies to undoing racism.

Research has found steeper drops in infant death rates in states that expanded Medicaid, and greater narrowing of racial gaps.

An impasse over Medicaid expansion between Cooper, a Democrat, and the Republican-led legislature has held up approval of parts of the state budget.

“It should come as no surprise that a baby’s health is impacted by a mother’s health, reinforcing why North Carolina needs to expand access to affordable health insurance,” Dr. Mandy Cohen, DHHS secretary, said in a statement.

The leading causes of infant death are premature births, being born underweight, birth defects, pregnancy complications and Sudden Infant Death Syndrome.

For the third year in a row, the mortality rate for white babies in North Carolina was 5 deaths for every 1,000 births, according to the report. For black babies, the rate was 12.2 deaths per 1,000. Death rates for black babies have fluctuated over the last five years but have declined over the last two years, from 13.4 deaths for every 1,000 births in 2016.

Reducing infant mortality

County public health offices, university clinics and doctors in private practice have been working to reduce the overall death rate and tackle the racial gap.

This year, Wake County launched a Best Babies Zone in southeast Raleigh, a effort to reduce infant mortality by focusing on community health and factors such as housing, education and employment.

“When you look at the data, there’s not one thing driving the decline,” Dr. Kelly Kimple, chief of the DHHS Women’s and Children’s Health Section, said in a telephone interview Monday.

Infant mortality is a reflection of several societal factors, she said.

“We have counties that are doing great work to try to decrease infant mortality,” she said. “A lot of these programs impact different risk factors or different things that we look at.”

She cautioned against drawing conclusions from counties’ year-by-year mortality rates because they fluctuate so much.

The gap between death rates for black and white babies in Wake County narrowed from 2017 to 2018, but the overall rates for black and white infants increased.

The gap in Mecklenburg County widened from 2017 to 2018. The death rate for white infants remained steady at 3 for every 1,000 births, but increased from 8.8 to 9.4 for African American babies.

In 1989, North Carolina had the second-worst infant mortality rate in the nation, according to the North Carolina Medical Journal. Then-Gov. Jim Martin to start a statewide effort to improve it.

In 1988, the mortality rate in North Carolina was 12.6 deaths per 1,000 births. Despite dramatic declines in infant death rates over the decades, North Carolina remained in the bottom tier of states in 2017, according to the Centers for Disease Control and Prevention.