November may be “Premature Birth Awareness” month but many in Indian River County are not aware that the county’s infant mortality rate ranks far higher than the national average, or that last week the state of Florida was once again awarded a grade of “D” on The March of Dimes annual Premature Birth Report Card.
For Kathie Cain, it’s not just the month of November that matters; it’s every day of every month. As executive director for the Healthy Start Coalition in Vero Beach, Cain knows the numbers and knows she has her work cut out for her. Premature births and infant mortality are serious problems here.
The County’s overall rate of infant mortality has reached as high as 9.6 per 1,000 births overall and it has had a disturbingly high rate of 30 infant deaths per 1,000 births within in the African-American community.
Worldwide an estimated 15 million babies are born prematurely each year and more than one million of them do not survive. Shockingly, the United State has one of the worst infant mortality rates among the world’s top 30 industrialized nations. According to the Centers for Disease Control and Prevention’s own figures, the U.S. ranks 26th on that list of 30 countries.
A September article in the Washington Post went even further. A baby born in the U.S., said the Post, is nearly three times as likely to die during his or her first year as a baby born in Japan or Finland and twice as likely to die as a child born in Korea.
Further complicating the challenge faced by Cain is the fact that she and Healthy Start are charged with much more than reducing the number of premature births. They have also been given a mandate for educating expectant mothers and providing both prenatal and postnatal care for every eligible child in the county.
Armed with a master’s degree in health care services administration and a master’s of business administration degree from Johns Hopkins University in medical services management, Cain says, “I take the challenge personally. We would love it if we weren’t needed but right now we are a safety net.”
Part of that safety net includes prenatal screenings to identify “at risk” pregnancies; attempts to secure insurance coverage for mothers-to-be and the scheduling of early prenatal appointments as well as a comprehensive maternal and child health in-home visiting program; support groups for mothers and fathers; infant screening to identify at-risk babies; a 24/7 phone counseling service and online infant care and breastfeeding support and education.
Pointing to a large county map on her office wall Cain says, “Every morning I wake up trying to figure out how I am going to reach these mothers in time to do the most good.”
Unfortunately, over a quarter of Healthy Start’s pregnant mothers don’t enter prenatal care programs until the second trimester of their pregnancy, so important information on diet, behavior and exercise frequently comes later than it should. Moreover, almost 20 percent of the mothers Healthy Start does see have already had previous “bad birth outcomes” including premature births, low birth weight or even stillborn infants.
Reaching those mothers, however, is only part of Cain’s job. She also has another outreach job to do. “Right now,” she explains, “we can’t handle all the cases we have. That’s why I’m trying to reach out to other non-profits and faith-based organizations. We need more support. We’re losing babies.”
Rose Parker, RN, director of nursing for the Florida Department of Health for Indian River County, is a big fan of the lifesaving work Healthy Start is able to accomplish with its limited funding. “By providing ongoing care coordination and support services to women and infants in Indian River County,” says Parker, “Healthy Start works to reduce the risks for poor maternal and child health outcomes. Their engagement and interventions have resulted in many heartwarming success stories for both mother and child.”
One of those heartwarming stories started in jail and ended up with a thank-you note to sheriff Deryl Loar. A pregnant young woman, jailed for petty theft, was taken under Healthy Start’s wing, went through the requisite programs and turned her life – and the life of her child – around.
She got a job at which she excelled, made restitution for the theft and when Sheriff Loar took part in “Dancing With Vero’s Stars,” one of Healthy Start’s fundraising events, she sent a thank-you note to the county’s top cop for helping her and for helping Healthy Start.
Success stories aside, perhaps the most frustrating thing Cain has to deal with is the public perception of some of the numbers she deals with every day.
A disease such as cancer causes almost 600,000 deaths in the U.S. each year, so an infant mortality rate of 6.2 deaths per 1,000 births, (the Florida average), may seem like a relatively small number by comparison. Cain’s response, however, is telling. “Fine,” she says. “You go up that maternity ward and you point out the six babies there who don’t deserve the chance to live.”
“Our fundamental goals,” Cain continued, “are to reduce infant mortality while also reducing the number of low birth weight and preterm babies in Indian River County. For me and for my board of directors, it’s all about the babies.”
With only 15 full-time workers and 11 part-time staffers, the Healthy Start Coalition of Indian River County, as well as the entire state of Florida, still has a long way to go before this particular safety net is as strong as it needs to be.