Poverty is Infant Health Risk

by Jeff Elliott

1 out of 5 infants at higher risk

One of the greatest health risks to an infant is not low birthweight, not inadequate prenatal care, and not smoking or drug abuse by the mother during pregnancy -- it's simply because the mother is poor, according to a new report from the Centers for Disease Control (CDC). Analyzing data from almost 15,000 women collected in 1988, the study found that infant mortality was 60 percent higher, and deaths in the first month were twice as high for women living in poverty. Women with incomes above the poverty line had a rate of 8.3 deaths per 1,000 infants, but 13.5 infants died for women in poverty. In 1988, one out of five mothers qualified as poor, defined as an annual income of $12,092 for a family of four.

Living conditions and availability of health services most important

Although a relationship between poverty and increased infant mortality in the United States was first noticed almost a century ago, little research has been done. Death certificates do not list the parents' income, for example, and most surveys of infant deaths have concentrated upon other factors, such as the number of times that the mother visited a doctor during the first trimester. Many also believed that the lifestyle of many poor women contributed to the higher percentage of deaths. The CDC report says that the mortality rate of infants born to high-risk women -- both above and below the poverty line -- was already so great that poverty had little additional effect. And while risk factors for mothers are often defined as being black, a smoker, adolescent, unmarried, or negligent of prenatal care, the CDC found the opposite to be true. The effect of poverty was strongest for infants who were otherwise at low risk -- born to women who were married, 18 or older, nonsmokers, white, had early prenatal care, or with at least a high school education. The CDC says the doubled risk of infant death during the first month is because of living conditions and financial barriers to health care. In particular, the Centers recommend increasing availability of medical services. Also helpful would be improving educational programs for new mothers, such as explaining the risk of dehydration with diarrhea, the need for child restraints in cars, and smoke detectors in homes. A statewide program in West Virginia is cited by the CDC as a successful example. In that state, infants at risk are linked with primary-care physicians who provide special health services.

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