Infant mortality is the number one indicator of health status in the world. Yet here in Indiana, more than 3,000 babies have died before their first birthdays in the last five years. That is enough to fill nearly 42 school buses. As an OB/GYN for more than 30 years, I have personally delivered thousands of babies and I understand the devastation and loss behind the statistics. These deaths are a disheartening reflection on the health of our state. We must get better at addressing the causes of infant mortality in Indiana.
More than two-thirds of Indiana adults are overweight or obese. More than 21 percent of our adults smoke. Among pregnant women in Indiana, the smoking rate is twice the national rate. At the root of the problem is the disparity in healthcare outcomes across Indiana. About 27 percent of all infant deaths in Indiana occur in three percent of the state’s ZIP codes.
The concentration of these deaths highlights significant racial and geographic differences. Additionally, 31 counties in Indiana either don’t have a hospital or are without a hospital that offers delivery services. Governor Eric Holcomb has set a goal of having the lowest infant mortality rate in the Midwest by 2024. To achieve that goal, healthcare resources will need to be refocused on the state’s highest-risk ZIP codes with the highest volumes of women of childbearing age. This means increasing utilization of these services by our at-risk populations and improving access to obstetrical care closer to home in our rural areas.
The Indiana State Department of Health (ISDH) is creating home visiting and community paramedicine partnerships to provide care along with community health workers to act as navigators for our obstetrical populations both during pregnancy and after delivery. We are promoting additional support to pregnant women through the Indiana Tobacco Quit line (1-800-QUIT-NOW). ISDH is also gathering data, mapping obstetrical service providers to determine gaps in access to care and studying the impact that Indiana’s opioid epidemic has on our state’s newborns so we can tackle it more effectively. Redirecting our healthcare resources to programs like these is the first step toward reducing Indiana’s disparities in maternal and infant care and creating a state where every person has an opportunity to live a long, healthy life.