Louisiana has the second highest infant mortality rate in the U.S.
CONCORDIA PARISH, La. (KNOE) - 79% of Louisiana is medically underserved. Concordia Parish has one of the highest infant mortality rates in the state.
KNOE’s Alyssa Azzara sat down with the Region 6 health director and a local pediatrician to talk about why these numbers are so high and what could be done to help bridge this great health divide.
Many mothers look forward to holding their newborn babies but some face a dark reality before their baby turns 1-year-old.
Concordia Parish has one of the highest rates at 14.5, more than double the national average. This means 14 out of 1,000 babies die before their first birthday.
Region 6 Health Director Dr. David Holcombe said there is a greater underlying issue that needs to be addressed.
“What it comes back to over and over and over again is poverty and lack of education, and inadequate job opportunities. So that’s the context that makes these cases seem to come up over and over again,” said Holcombe.
He said infant mortality is usually related to low birth weights, and low birth weights can be due to a number of things.
“They can be related to low maternal, low maternal age, poor prenatal care, or inadequate prenatal care. And high frequency between pregnancies, so inadequate spacing, and all of those things are, unfortunately, much more prevalent in the African American community than in the white community,” said Holcombe.
Holcombe said some deaths are truly unavoidable. Babies may die at birth due to genetic issues but he said the majority of infant deaths are due to Sudden Infant Death Syndrome and suffocation.
“Many of those are sudden infant death syndrome, which has no obvious explanation, but right after that comes suffocation from rollovers and co-sleeping,” said Holcombe.
Many rural health clinics do not offer OBGYN services. The closest OBGYN doctor for Concordia Parish is in Natchez, Mississippi.
Holcombe said another reason is mothers are too busy for routine checkups, where most of the education happens.
“They have two or three jobs, they have kids at home, they have to take care of, they may have to take care of their elderly parents, they don’t have any transportation. I mean, there’s all this chaos in folks’ lives related to the fact that they have low-paying jobs or no paid jobs at all,” said Holcombe.
Since many cases come from Sudden Infant Death Syndrome or suffocation from co-sleeping, Dr. Carrie Bonomo said she educates mothers on how to put their baby to sleep when they come in for their two-week visit.
“Don’t use any pillows, or blankets, or stuffed animals. And I tell them, you know, no wedges because some moms like to use wedges and put them on their side, they’re afraid to let them sleep on their backs, especially if they’re splitters. So I tell them, you know, make sure they stay on their back,” said Bonomo.
Bonomo said do not sleep with your baby. Instead, have your baby sleep in a bassinet next to your bed.
Bonomo is no stranger to infant deaths.
“A child was accidentally put down on his stomach instead of being put on his back. And then mom fell asleep. I was planning on turning him over and mom fell asleep. And when she woke up, realized that she had fallen asleep, because they’ve been up all night, that he was sleeping with his face down on the mattress,” said Bonomo.
Bonomo is the only permanent pediatrician located in Concordia Parish.
“I mean, there’s no doubt about that, this is a very underserved area,” said Bonomo.
“And just primary caregivers in general, are underserved. I mean, and as far as pediatrics and a small rural area, it just doesn’t happen very often,” said Bonomo.
She said more doctors in Concordia Parish would be a good start but there is little incentive for caregivers to move from larger cities to rural areas.
Region 6 health director said lawmakers need to recognize the medically underserved areas.
“What I’d really like to see then is I’d like to see adequate investment in these underserved areas for job training, job investments, improve schools,” said Holcombe.
Holcombe said the recent Medicaid expansion, more federally qualified health centers, and rural health clinics are a step in the right direction. However, he said it will be difficult to lower the infant mortality rate without addressing the poverty in Concordia Parish.
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