[Congressional Record Volume 156, Number 115 (Monday, August 2, 2010)]
[Senate]
[Pages S6581-S6582]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    NATIONAL INFANT MORTALITY MONTH

  Mr. CARDIN. Mr. President, I rise today to discuss a resolution I 
have submitted supporting the goals and ideals of National Infant 
Mortality Awareness Month. I am joined by my colleague from North 
Carolina, Senator Burr, in drawing attention to this important health 
issue.
  Infant mortality is an important indicator of the health of a nation, 
and since 2000, the infant mortality rate in the United States has 
remained stagnant, generating concern among researchers and 
policymakers. The United States ranks 29th among industrialized 
countries in the rate of infant mortality, with 6.8 deaths per 1,000 
live births in 2007, according to the National Center for Health 
Statistics.
  The primary reason for the United States' higher infant mortality 
rate is the higher percentage of preterm births, that is, babies born 
before 37 weeks of gestation. In 2004, one in eight infants born in the 
United States was preterm, compared with one in 18 in Ireland and 
Finland. Among reported European countries, only Austria has a 
comparable preterm birth rate; the other countries, including England, 
Sweden, and France, have far lower rates. Preterm infants have much 
higher rates of death or disability than infants born at full term. In 
fact, if the United States had the same gestational age distribution of 
births as Sweden, with fewer preterm births, the U.S. infant mortality 
rate would decrease by about 30 percent. These data from the National 
Center for Health Statistics suggest that preterm birth prevention is 
crucial to lowering the U.S. infant mortality rate.
  The rate of preterm births in the United States rose by one-third 
between 1984 and 2006, and in 2004, the National Center for Health 
Statistics reported that 36.5 percent of all infant deaths in the U.S. 
were related to premature birth. This accounts for 12.5 percent of 
babies born in the United States. In addition to contributing to a 
higher infant mortality rate, this high rate of premature births 
constitutes a public health concern that costs society more than $26 
billion a year, according to a 2006 Institute of Medicine report.
  There are indications that the situation is improving. Following a 
long period of steady increase, the U.S. preterm birth rate declined 
for the second straight year in 2008 to 12.3 percent, from 12.8 percent 
in 2006, marking the first two-year decline in the preterm birth rate 
in nearly three decades.
  We have seen similar trends in my own state of Maryland, where the 
infant mortality rate decreased by ten percent from 2008 to 2009, 
improving from 8 infant deaths per 1,000 live births to 7.2 infant 
deaths per 1,000 live births.
  The Centers for Disease Control and Prevention reports that despite 
these positive trends, significant racial disparities in infant 
mortality rates persist. In 2006, the infant mortality rate for 
African-American infants in the U.S. was more than twice the rate for 
non-Hispanic White infants, at 13.4 deaths per 1,000 live births for 
African-Americans compared to 5.6 for non-Hispanic Whites. In American 
Indian and Alaska Native populations, the death rate is 50 percent 
higher than in non-Hispanic Whites, and the sudden infant death 
syndrome, SIDS, mortality rate for this population is also twice as 
high as the SIDS mortality rate for non-Hispanic Whites. The Puerto 
Rican population also experiences significant disparity in this area, 
with an infant mortality rate 40 percent higher than that for non-
Hispanic Whites.
  Disparities in prenatal care also contribute to higher infant 
mortality among minority populations. Nationwide, African-American 
mothers were 2.5 times more likely than white mothers to receive late 
or no prenatal care. This trend is also evident in Maryland, where in 
2009, the number of babies born to all mothers receiving late or no 
prenatal care was 4.7 per 1,000 live births, but the number of babies 
born to African-American mothers lacking prenatal care increased from 
6.3 per 1,000 live births in 2008 to 7 in 2009. A lack of prenatal care 
can contribute to low birth weight and increased risk for

[[Page S6582]]

birth defects, which can cause higher infant mortality rates. So, 
despite the progress we are making in reducing infant mortality, 
evidence of the progress is not being seen equally everywhere.
  To combat these disparities, the HHS Office of Minority Health, OMH, 
began the ``A Healthy Baby Begins with You'' campaign in 2007. This is 
a nationwide effort to raise awareness about infant mortality with an 
emphasis on African Americans. The goals of this campaign include 
reaching the college-age Black population with targeted health messages 
emphasizing preconception health and health care. The campaign trains 
college students to be health ambassadors and reaches out to 
historically Black colleges and universities and other minority-serving 
institutions.
  Based on the success of that campaign, OMH developed the 
Preconception Peer Educators Program, launched in 2008. This program 
addresses the need to emphasize preconception health as an important 
factor influencing outcomes for maternal and infant health. The program 
enlists college students as peer educators on college campuses and in 
communities to disseminate essential health messages that may seem 
irrelevant to students who are not seeking to start a family. Because 
more than 50 percent of pregnancies are unplanned, good preconception 
health is essential. This program has held trainings across the country 
over the past year, and there will be a national training for the PPE 
program this September during National Infant Mortality Awareness 
Month.
  I also commend the work of the Maternal and Child Health Bureau at 
the Health Resources and Services Administration for providing national 
leadership on the issue of infant mortality. Their efforts provide 
critical insight into the Nation's progress toward ensuring quality of 
care, eliminating barriers and health disparities, and improving the 
health infrastructure and systems of care for women and children. All 
of these areas influence the infant mortality rate, and the work of the 
Maternal and Child Health Bureau will help target our resources 
efficiently to decrease the number of infant deaths nationwide.
  Although some indications are that the U.S. infant mortality rate is 
decreasing, there is room for substantial improvement. In some pockets 
of the country, including Baltimore, Memphis, and Washington, DC, the 
rate is more than twice the national average, and evidence of racial 
disparities in this area cannot be ignored. We must continue to 
research the causes and contributing factors to infant mortality and to 
support effective education and awareness campaigns so that mothers get 
the prenatal care that they need to have healthy babies. I thank my 
colleagues who have agreed to support this resolution drawing attention 
to National Infant Mortality Awareness Month in September and to 
support Federal efforts to decrease our national infant mortality rate.

                          ____________________