
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, April 9, 1995                   TAG: 9504130013
SECTION: EDITORIAL                    PAGE: G-2   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

TOO MANY BABIES STILL DIE IN VIRGINIA

VIRGINIA'S infant-mortality rate continues to decline. That is certainly welcome news in a state with an infant-death rate so high a decade ago that a child born in Singapore was said to have a better chance of surviving than one born in Roanoke or Richmond or Norfolk.

In 1993 - the most recent year for which complete figures are available - Virginia's infant-mortality rate dropped to 8.6 deaths per 1,000 births, from 9.3 per 1,000 the year before.

Though the state rate is still somewhat higher than the national rate of 8.3 deaths per 1,000 births, Virginia in recent years has made more rapid progress reducing its rate than has the nation as a whole. State Health Department officials attribute this to improved access to medical care. Virginia, they say, apparently will meet the national objective of no more than 7 infant deaths per 1,000 births by the year 2000.

In all this statistical good news, however, there is this disturbing reality: The infant-mortality rate for black Virginians remains significantly higher than for whites - as it has been historically. For blacks, it was 14.7 deaths per 1,000 births in 1993, down from 17.2 the year before. The rate for whites was 6.6, down from 6.9 in 1992.

This decrease for blacks is dramatic, and reason for optimism. Even so, a black baby born in Virginia is twice as likely to die before it reaches its first birthday than is a white baby. The new figures say the chances for a Virginia black baby's survival today aren't yet as good as chances for a Virginia white baby's survival 20 years ago, when the infant-mortality rate for whites was 15.1 per 1,000 births. The figures point to the persistence of an unacceptable health gap between the races.

Reducing infant-mortality rates is a challenge not only for public-health officials. Infant mortality is closely linked both to the quality of medical care available to expectant mothers and to the socioeconomic conditions into which children are born. These conditions include unemployment, low income, limited education and poor housing - all beyond the purview of health officials alone.

Into this mix add also the absence of the father in the home. ``The most worrisome related demographic trend is the increasing lack of male responsibility, which we measure through births to single women or out-of-wedlock births," says Dr. Donald Stern, former health commissioner for Roanoke and now acting state health commissioner. "A modification of behavior plus public policies that promote families having a mother and father are key to more significant reductions in infant deaths. Clearly, an essential part in reducing infant mortality rests with fathers and mothers taking responsibilities for the children they bring into the world.''

Meanwhile, though, public-health officials can do more to close the health gap - if given adequate resources. Access to prenatal clinics and preventive medical care for babies has improved, but remains difficult for many, especially in larger and poorer urban areas. Health officials need to do more reaching out: taking health services into those neighborhoods, and beaming health-education campaigns into them.

The goal should be zero tolerance for preventable infant mortality - which is to say, most infant deaths. Virginia is nearer the goal than before, but there remain more miles to travel.

by CNB