The number of Northeast Florida babies who died before their first birthday dropped in 2015 after remaining stagnant for two years.
The 132 deaths were preceded by 143 in 2014 and 141 in 2013, according to the Northeast Florida Healthy Start Coalition’s annual Fetal and Infant Mortality Review.
From 2014 to 2015 the so-called infant mortality rate for Baker, Clay, Duval, Nassau and St. Johns counties dropped from eight deaths for every 1,000 live births to 7.1, according to the report released Thursday.
The infant mortality rate dropped 37 percent in Jacksonville’s urban core, an area where the rate has been historically high, and the region’s fetal death rate dropped from 8.3 deaths per 1000 live births to 7.1 deaths.
But there were still stubbornly high numbers in some areas. Finding out why some areas are doing well and others are not is the reason for the review, said Tracy Claveau, the coalition’s Fetal & Infant Mortality Review project coordinator.
“The infant mortality rate is often used as an indicator to measure the health and well-being of a population,” she said. The intent of the annual review process — not just gathering numbers but getting to the root of them — is “to determine specific medical, social, financial and other issues that may have impacted the poor birth outcome. It’s not about finding fault, it’s about figuring out where the system failed,” she said.
Here are some of the review’s most troubling findings:
• About 18 percent of all 2015 infant deaths in Northeast Florida were sleep-related, up from 16.8 percent in 2014. Bedsharing was a factor in 58 percent of the region’s sleep-related deaths.
• The region’s infant mortality rate still tracks higher than the state rate, which was 6.2 deaths per 1000 live births in 2015.
• Racial disparities continue. Last year, non-white mothers were almost twice as likely to experience a fetal death and almost 2 1/2 times as likely to experience an infant death as white mothers.
• Two Jacksonville ZIP codes in largely low-income areas — 32210 and 32218 — lead Duval County infant deaths for the third year in a row and account for about 19 percent of Northeast Florida infant deaths. Seventy-five percent of the babies who died in those two ZIP codes were non-white.
• Baker, Clay and Nassau counties are in the top 10 counties in the state for infants born “substance exposed,” according to the report. Duval County had Florida’s highest number of infants — 450 — born with a drug-withdrawal syndrome tied primarily to opioid use.
• The leading causes of infant deaths in the region last year were prematurity or low birth weight; other conditions that affect the mother directly before or just after the birth of a child, such as cardiac, kidney or digestive abnormalities; and Sudden Unexpected Infant Deaths.
Such data gives the coalition “important information about what drives our fetal and infant deaths — the issues that specifically impact our moms and babies here in Northeast Florida,” said the Rev. Tom Rodgers, the agency’s vice chairman. “We know from these reports that our families are dealing with substance use, that babies aren’t placed alone, on their back or in a crib, leading to a rise in sleep-related deaths, that a mother’s health prior to pregnancy has the biggest impact on whether her baby will be born healthy. By digging down into the causes and contributing factors, we can work with our programs and community partners on strategies and solutions that ensure more of our babies reach their first birthday.”
The greatest need, according to the report, is improving women’s preconception health.
“A woman’s health prior to pregnancy has the largest impact on birth outcomes in Northeast Florida,” according to the report, which cited hypertension, diabetes, obesity, sexually transmitted diseases and infections, too short intervals between pregnancies and substance abuse as factors.
Also, parents and caregivers must be better educated about the importance of “safe sleep” practices and maintaining healthy lifestyles during and after pregnancy.
As part of the review process, a multi-disciplinary team examined 19 infant death cases and nine fetal death cases and reviewed additional related data and cases. The team made recommendations that will be implemented by a Community Action Team. The recommendations stemming from the 2015 review were:
• Spreading the word about unsafe sleep practices, such as infants sleeping in the same space as a parent or caregiver. Babies should be put to sleep alone, on their back, in a crib, bassinet or pack and play, according to the coalition.
The coalition will soon relaunch the Northeast Florida Safe Sleep Partnership, including local agencies and community members, “to develop strategies and initiatives,” according to the coalition website. The coalition already has its Nurse-Family Partnership, a home-visiting program that service high-risk mothers in Jacksonville through two Healthy Start providers, and contracts with local organizations to provide Healthy Start case management services for at-risk infants.
In addition, a “safe sleep” marketing campaign will be implemented this month.
• Getting women into a regular health care routine early in pregnancy. That means working with doctors, clinics, Medicare and managed-care organizations to more quickly connect pregnant women with obstetric care. In many cases the pregnant women may not have even had a primary care doctors prior to pregnancy, according to the report.
The coalition has already been working to address the preconception health care gap, including opening a primary care clinic in Jacksonville’s urban core, among other programs.
• Establishing a centralized location, possibly a website or Facebook page, for “obstetrician-related activities” in Northeast Florida. The site would include pregnancy-related facts and links to classes and resources, according to the report.
Beth Reese Cravey: (904) 359-4109