Health & Fitness

Hispanic infant mortality isn't declining — and that worries one Wichita group

Maribel Vasquez and her baby boy Isaiah at home in south Wichita. (May 8, 2018)
Maribel Vasquez and her baby boy Isaiah at home in south Wichita. (May 8, 2018) The Wichita Eagle

In 2016, 223 babies died in Kansas before reaching their first birthday.

Overall, fewer babies are dying in the state. But some researchers are worried that the trend is moving in the opposite direction for Hispanic babies.

“There’s something going on in that community that we need to figure out and help address,” said Cari Schmidt, director of the Center for Research for Infant Birth and Survival (CRIBS). The center, founded last year, is housed at the University of Kansas School of Medicine-Wichita campus.

Hispanics have historically had low infant mortality rates, despite lack of access to education and prenatal care.

But Schmidt fears that is changing, that Hispanic babies are becoming more likely to die during that first year.

Factors could include adapting to American culture or stressors during pregnancy.

The data

The death of an infant under 1 year old is relatively rare, making it difficult to compare data. In 2016, 223 infants died in Kansas. In 2015, 230 infants died in the state.

The Kansas Department of Health and Environment offers a comparison in one report by looking at infant mortality rates based on five-year averages from 1997 to 2016.

That graph shows that infant mortality rates have declined for babies born to white or black mothers — although the rates for black babies are still more than double those for white infants.

The infant mortality rate for infants born to Hispanic mothers has fluctuated from year to year. It has not declined when looked at by five-year averages. Over the past 20 years, the rate has increased in Kansas.

The amount of increase isn’t statistically significant, according to a 2016 KDHE research brief, but it’s enough to concern Schmidt.

What worries Schmidt is that while the rates are declining for other groups, they are rising — however slowly — for Hispanics. Part of the center’s goal is to research what drives those disparities.

Stress

One possible reason for the increase is toxic stress. In the past, researchers investigated eating habits, obesity, prenatal care and more to explain the disparity in infant mortality between black and white infants. Recently, researchers have said it is more likely that racial disparities come from social mechanisms and class disparities.

Essentially, discrimination and racism cause toxic stress for black mothers, affecting the birth weight and overall health of their children, according to Nancy Krieger, professor of social epidemiology at Harvard T.H. Chan School of Public Health.

Much of the research has focused on black mothers. However, one group of researchers considered the impact of immigration raids on the health of babies born in Latino communities.

After the U.S. Immigration and Customs Enforcement agency detained nearly 400 workers in a raid in Iowa, researchers studied the birth weights of both Hispanic and white infants in the nine months after the raid as well as the nine months preceding the raid.

They found that throughout the state, infants born to Latina mothers after the raid were 24 percent more likely to be born at a low birth weight than those born before the raid (for both immigrant and U.S.-born mothers). There was no change in birth weight for the infants of white mothers.

The study was published in the International Journal of Epidemiology last year.

Martha Henao, Spanish education coordinator with CRIBS, said the political climate and ICE raids could easily affect a mother’s health.

“What are you going to do if you get deported or your husband gets deported and you stay here — and what’re you going to do with baby, because baby’s going to have American citizenship if they’re born here?” she said.

For Maribel Vasquez, a Wichita mother of three, it was bad news about her mother that caused stress during her pregnancy, which was otherwise healthy.

She participated in a Spanish-language version of CRIBS’ BabyTalk program, which offers classes on labor and delivery, having a healthy pregnancy and infant care.

There and at regular doctor’s appointments, she was able to talk about her stress and depression. She learned that it was important to let go of any negative feelings, since those emotions can affect the baby, she said.

Acculturation

Another theory, Schmidt and Henao said, is that the longer Hispanic immigrants live in the United States, the more likely they are to adapt to unhealthy behaviors such as smoking and bottle feeding.

Since the issue of infant mortality can involve everything from toxic stress to safe sleep, a solution isn’t necessarily easy.

Factors often are compounded, Schmidt said. One example is how a baby born prematurely (perhaps due to the mother’s stress) is already at high risk. Then, if the baby is placed in a smoking environment or with toys in the crib, more risks pile up.

It’s not enough to just teach mothers about safe sleep, experts say. If only mothers are taught, then what happens when the child is in the care of a babysitter?

“This is why we have to pull in so many different partners and collaborators,” Schmidt said.

The work

Four months ago, Vasquez gave birth to a healthy boy named Isaiah. BabyTalk was a great support for her, she said, especially as she went through a difficult time.

Now, she said, she wishes she had another group where mothers could exchange ideas about raising kids and continue to support one another after their babies are born.

At CRIBS, which opened last year, they’re still gearing up to make a difference. They plan to research infant mortality rates and are working to increase access to prenatal, post-conception and mental health care. They are looking at substance use during pregnancy and working to encourage safe sleep guidelines for infants.

They’re also targeting Hispanic infant mortality rates specifically through programs such as the Spanish-language BabyTalk and Spanish-language community baby showers.

The BabyTalk program isn’t simply a matter of translation, Henao said. Rather they need to modify examples and some information to be applicable to Hispanic cultures. Already, they’ve finished two pilot classes with expectant mothers.

Katherine Burgess: 316-268-6400, @kathsburgess.

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