Shantae Johnson, a peer support member with the county's Healthy Birth Initiative, promotes healthy lifestyle choices to other women.

In Multnomah County, the goal is that all babies celebrate their 366th day of life.

That is especially true for the county’s African American and Native American babies who are nearly twice as likely than non-Hispanic white infants to die within their first year of life.

At a Board of Commissioners meeting on Thursday, Sept. 27, health experts testified that the community must address a range of health factors to tackle the health disparity. At the same meeting, the board proclaimed September as Infant Mortality Awareness Month. Commissioner Loretta Smith introduced the proclamation saying it was a reminder about caring for infants, "the county's cutest residents."

Infant mortality is often an indicator of a community’s overall health because it encompasses other health factors including maternal health, socioeconomic status, exposure to chronic stress and access to health care.

With 9.1 deaths per 1,000 births, African Americans have the highest infant death rates in Multnomah County. Native American babies die at a rate of 9.0 deaths per 1,000 births.

Rachael Banks, director of the county’s Healthy Birth Initiative program, said infant mortality and other poor birth outcomes, such as low birth weight and premature births, not only affect families, but health systems and the overall community as well.

Infant mortality and poor birth outcomes also come at a monetary cost.

There is a significant savings when mothers can add a few ounces to a baby’s weight before birth. An increase of about a half-pound in birth weight can save an average of $12,000 to $15,000 in the first year of medical expenses. Prenatal interventions that result in a normal birth weight of more than 5.5 pounds saves nearly $60,000 in medical expenses in the infant’s first year.

County initiatives, such as the Healthy Birth Initiative and Future Generations Collaborative, show that the county’s strategies “really show its commitment to addressing equity and to do its part in preparing children to be ready to learn when they walk into kindergarten.”

The Healthy Birth Initiative is the county’s effort to improve the health and job opportunities for African American mothers, fathers and young children through home visits, health education and support groups. The Future Generations Collaborative addresses substance abuse before, during and after pregnancy among women ages 15 to 24 in urban Native communities.

The county also offers home visits, mobilizes community partners, hosts community-wide educational opportunities on financial planning, parenting, preterm labor causes as well as studies the root causes and barriers to parents raising healthy children.

Roberta Eaglehorse, a Native American community health worker, told commissioners that she tries to help women by educating them about resources and helping them to feel more comfortable accessing services. One of the obstacles for the Native American community is getting them to trust the organizations that provide aid, Eaglehorse said. However, that mindset changes through collaboration with community partners, she said.

“Once we start holding our children sacred and special, the more that other people will,” said Eaglehorse, who also participates in the Future Generations Collaborative.

Jessica Guernsey, health department maternal child health director, said one of her priorities is to address the long-standing racial and ethnic disparities in the county that persist despite advancements in health care. She says community collaboration is a proven way to protect families and children.

But there’s more work to be done.

“It’s hard to believe that 40 other countries have a lower infant mortality rate than the U.S.,” Guernsey said.

By the numbers

• 906 babies are born in Oregon each week. Of those babies:
• 89 are preterm
• 57 are born low birth weight (under 5.5 pounds)
• 5 babies a week, on average, will die before their first birthday
• 10-15 percent of all newborns will be admitted to a neonatal intensive care unit within first months of life
• direct healthcare costs to employers for a preterm birth are 11 times higher than for a baby born healthy and full-term
• cost to employers for maternal healthcare, including prenatal care, delivery, and postpartum care, increases 75 percent with a diagnosis of prematurity
• 25 percent of premature babies will have a lifelong disability, blindness, cerebal palsy, hearing disorders and developmental delays

Source: Beth Joscelyn, Oregon state director of March of Dimes