Detroit infant mortality rate worst among large US cities

By Khara Sikhan
4 February 2014

A Detroit News exposé details the grim reality of infant mortality in Detroit. The report finds that infant mortality averaged 14.7 for every 1,000 live births between 2000 and 2011. The highest rate was in 2002, when the average rate of mortality was 16.8 per 1,000 live births.

Detroit’s infant mortality rate is the worst among the large US cities, and worse than in some developing countries. For comparison, Malaysia averages 14.57 deaths, Costa Rica averages 9.2 deaths, and Saudi Arabia averages 15.61 deaths per 1,000 live births.

High infant mortality is attributed to various factors, including inadequate prenatal care, premature birth, and mothers living in stress and social chaos. Infant death rates are highest for mothers younger than 20 years old. Unmarried mothers have infant mortality rates nearly twice those of married mothers.

Women receiving inadequate prenatal care experience infant mortality rates three times higher than women receiving adequate prenatal care. Mothers exposed to smoke and carbon monoxide while pregnant had an infant death rate of 9.6 per 1,000 live births compared to a rate of 5.5 for mothers living in a cleaner environment.

Chronic poverty is the underpinning reason for such high infant mortality rates in Detroit. Detroit’s real unemployment rate is 50 percent, and those employed earn a median of $25,000—half the national median, and just above the national poverty line.

Detroit once had one of the highest working class standards of living in the US. Since 1950, Michigan has lost 90 percent of its better-paid manufacturing jobs. Between 2000 and 2010 alone, Michigan lost more than 400,000 manufacturing jobs. All sectors of the state’s economy have seen wages slashed through corporate restructuring or emergency manager dictates.

Household poverty among the Detroit population now stands at 41 percent. Supplemental income is absolutely necessary for anyone working for less than $10,000 a year for multiple years. However, in 2011, the State of Michigan began retroactively enforcing a 48-month lifetime cap on welfare benefits, ending assistance for 27,000 families to date.

Paying for skyrocketing costs in health care requires assistance as well. Medicaid will reimburse doctors 50 cents per dollar, and many doctors cannot afford such low rates and have stopped accepting Medicaid. The 2010 US Census found that 73.8 percent of the city is medically underserved.

President Obama’s Affordable Care Act (ACA) is the latest move toward dismantling the health care safety net for the working class. Under the legislation commonly known as Obamacare, millions of the uninsured will be required by law to purchase insurance from private insurers that carries high premiums and huge out-of-pocket costs, with only minimal government subsidies available for those who qualify. Others will be shifted to Medicaid. Between 1996 and 2010, Medicaid funding for Michigan hospitals was reduced by $900 million.

As a result of the US sequester cuts, Michigan cut $23 million from Community Health, including $10 million from SNAP (Supplement Nutrition Assistance Program—food stamps), affecting one in five people in Michigan. Governor Rick Snyder insisted that lost federal funds would not be replaced with state dollars.

Access to doctors and hospital care is another major factor in the poor health of Detroit citizens. Outside the major hospitals, there is only a handful of private practice OB-GYNs within city limits.

In 2010, then-Detroit Medical Center (DMC) CEO Mike Duggan sold four of the last six non-profit hospitals to Vanguard Health Systems, owned by private equity firm Blackstone Group. The DMC is the largest employer in Detroit, and 70 percent of DMC patients are Medicare or Medicaid recipients.

In 2012, the DMC aimed to increase profits by cutting staff expenses. Included in the cuts were a large number of nurse midwives and full clinics from the Hutzel Women’s Hospital. Those nurses were recruited out of Detroit to join Oakwood Healthcare in suburban Dearborn. In 2013, the DMC announced plans to lay off 300 workers as a response to the federal sequester cuts, which eliminated 2 percent of its Medicare funds.

Mike Duggan is now the mayor of Detroit, elected in November 2013. Duggan has come forward after the Detroit News report with an initiative to prevent infant death. He laid blame on doctors, encouraging doctors to “embrace best strategies for reducing preterm births,” and proposes a public campaign to reach pregnant women. Snyder pointed to a campaign to stop parents from sleeping with their children, implying that this is one of the main drivers of infant mortality.

While feigning concern for the plight of mothers and infants, both Duggan and Snyder are part of the for-profit dismantling of the City of Detroit. In reality, there is very little support for helping young mothers continue in high school in a city with a teen pregnancy rate of 18 percent. In 1986, Catherine Ferguson Academy was opened to provide public schooling for pregnant teens, teenage mothers, and infants. In 2011, it faced closure by DPS Emergency Manager Robert Bobb but was reopened as a for-profit charter school.

These young mothers often rely on their parents or grandparents for support. Detroit is currently aiming to loot pensions from retirees, proposing a “negotiation-based” deal to give pensioners 25 cents on the dollar. This effectively cuts the average pension from $20,000 a year to $4,500, and the effect will snowball onto successive generations.

DTE Energy plays a role as well. In 2010, the Committee Against Utility Shutoffs exposed the role of DTE in promoting utility shutoffs, homelessness, malnutrition, ill health, and poor child development. This year alone has seen multiple children dying in house fires caused by utility shutoffs; in 2013, an infant died along with two siblings in a devastating house fire.

Detroit is the economic testing grounds for the capitalist class: it is on the forefront of closing jobs and slashing wages, gutting social spending, and privatizing city services. Detroit has been turned into a perfect storm of societal destruction based on the looting of funds for social services. Safe transportation, housing, and medical care are all requirements for healthy pregnancy. The attack on these basic social rights is reflected in the new infant mortality figures.

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