For the first time in four years, Tarrant County isn't leading the state's largest counties in infant mortality rates, but the rate of babies dying before their first birthday is still higher than in Texas and the nation.
A report released this week by Tarrant County Public Health revealed that infant mortality dropped for a second straight year, from 7.2 deaths per 1,000 live births in 2008 to 6.7 in 2009, the most recent year with data available. The county's rate had been as high as or higher than those of Dallas, Harris, Bexar and Travis counties since 2005, when Tarrant recorded 8.2 deaths per 1,000 live births.
The statewide rate is 6 and the national rate is 6.4, according to the health department.
"You cannot rejoice because there is a great drop this year. You can't rejoice until there is a consistent drop," said the department's Dr. Anita Kurian. "We haven't seen that yet."
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Though health officials say a new focus on improving women's well-being long before they become pregnant helped reduce infant deaths overall, certain communities are still more at risk than others. Advanced care for premature babies simply can't save them all.
"We have awesome care for premature babies, very heroic care," Kurian said. "When you have such a large number of premature births, some of them are not going to make it."
Higher among blacks
The infant mortality rate among African-Americans fell 40 percent in Tarrant County from 2005 to 2008, but black women are still more likely than those of other races or ethnicities to deliver a baby with a very low birth weight.
In 2009, the African-American infant mortality rate was three times as high as that for Anglos and twice as high as for Hispanics. It was 12.6 among blacks, up from 11.7 in 2008; 6.5 among Hispanics, up from 5.1; and 4.2 among Anglos, down from 7.2.
"All this work toward improving maternal health is working but at a slower pace for African-Americans," Kurian said.
Better prenatal care isn't the only solution if a woman is obese, abuses drugs or alcohol, or has a chronic illness such as diabetes or hypertension, Kurian said.
"It's difficult to tackle those risk factors just during those nine months of pregnancy," Kurian said. "You can't expect prenatal care to eliminate all the health inequalities that have accumulated over a person's life."
So for the past decade, the Infant Mortality Network of Tarrant County and other agencies have worked to educate women about how they can help not only themselves but also their future children by exercising, eating right, managing chronic illnesses, and avoiding drugs and alcohol.
"When we very first started, everyone thought they already knew the answer and that answer was we need better access to prenatal care," said Ann Salyer-Caldwell, the network's chairwoman. "Our access to healthcare is not perfect, but it's much better than it ever was. So why is the infant mortality rate so high? It all really ties back to poor maternal health and prematurity."
County health officials are also taking an active role in the lives of some at-risk babies even after they leave the hospital.
Tarrant County's Nurse-Family Partnership Program provides low-income women with free one-on-one medical care and emotional support through pregnancy until their child turns 2.
Besides prenatal care and nutritional advice, participants are also connected with area resources to help them reach their educational and employment goals so they can become self-sufficient.
Decrease in Arlington
Arlington leaders celebrated news that the city's infant mortality rate dropped from 8.2 in 2008 to 6 in 2009.
"Tears came to my eyes. It was just something I never would have believed," said former Councilman Joe Bruner. He and his wife, Doreen, launched the Life Through Literacy Foundation in 2007 to support programs aimed at reducing illiteracy and infant mortality in Arlington.
The foundation has largely financed an Arlington Public Library outreach program that has provided dozens of pregnant and parenting teens in Arlington schools with books and educational materials to create healthy home environments. The classes aim to help young parents bond with their babies by singing or reading to them in the womb and to promote good health and literacy.
"The ultimate goal would be to not have young mothers, to teach them to abstain and to not get pregnant. We know that is not going to happen," Bruner said. "We've got to have more people teaching these young people to take care of themselves through nutrition and prenatal care."
Fort Worth's infant mortality rate rose slightly in 2009, from 7.7 to 8.2. Dallas' increased from 6.1 to 8.
Dallas County's rate, 7.3, was the highest among Texas counties with 10,000 or more live births. That knocked Tarrant County to second place, followed by Harris, Bexar and Travis counties.
"We don't want to be No. 1. Sometimes being first isn't a good thing," Salyer-Caldwell said.
Susan Schrock, 817-709-7578