Reporting on persistent disparities in North Carolina’s infant mortality rate

North Carolina's high infant mortality rate has been the topic of official state reports and politicians' denunciations since I've been a reporter here — more than 20 years. 

The infant mortality rate in North Carolina is higher than the national average, and the rate for African American babies in the state is more than twice as high as the rate for white babies. 

We will present a series of articles that looks at the toll the high infant mortality rate has on families, the reasons behind the disparity, and what's being done in North Carolina to narrow it. 

There's new attention to racism as a contributor to higher death rates. The project will look at nonmedical factors that determine health, and how communities are addressing them. 

North Carolina has been focused for years on reducing the infant mortality rate. The overall rate declined, but North Carolina still ranks in the bottom fifth nationally, and disparity between the rates of African American and white infant deaths persists.

The state in 2016 adopted a five-year plan to improve perinatal health. The gap in infant mortality rates has narrowed, but results have been inconsistent.  

There's a misconception that the problem is confined to rural counties with high levels of poverty, places where it can be difficult to find health care. 

Some rural counties do have yawning gaps between black and white infant mortality rates, but the gaps are also wider than the state average in urban counties, including Durham, Wake, and Mecklenburg counties. In Charlotte, the state's largest city, the death rate for African American babies was five times higher in 2016 than it was for white babies. 

In Wake, the state’s capital county, the death rate for white infants was 1.9 per 1,000 in 2017, while for African American infants it was 11.4.  

Preliminary numbers for 2018 show that African American infants accounted for fewer than one-quarter of the births in the state and nearly 42 percent of the deaths. More black babies died last year in the state than white babies.

Our project will look at the state's plans for narrowing the mortality gap — what has worked, what hasn't and why, and what it's going to try next. 

The project will explore strategies tailored to individual and community needs, gaps in heath-care availability, and funding. 
North Carolina is one of the states that has not expanded Medicaid under the Affordable Care Act, reducing the chances that women without health insurance have routine medical checkups before pregnancy. Would Medicaid expansion reduce the racial disparity in deaths of children younger than a year old? 

We will look at what happened to racial disparities in infant mortality in states that expanded Medicaid. 

State health officials are bringing renewed focus to narrowing the infant mortality gap as part of an effort directed by the governor to improve early childhood health and education. 

The project will also look at family leave and subsidized childcare policies and their effects on economic stability and family health. Do a state Earned Income Tax Credit or paid sick leave help improve family health? 

Our project will include video, still photographs, and maps. 

We want to talk to families. Please contact me at lbonner@newsobserver.com or (919) 829-4821.