Two zip codes on San Antonio’s Eastside have a Hispanic infant mortality rate that is twice the statewide average, a new University of Texas System study found.
While infant death rates in Texas are lower than the national average, substantial variations exist by race and geography, according to the study released Thursday.
“We shouldn’t feel so comfortable with a lower state average when we have these pockets of communities across the state with such profound variations,” said Dr. David Lakey, UT System chief medical officer and vice chancellor for health affairs, who contributed to the report. “Right now we are just below the national average, which is not to say we are doing much better.”
The UT System study found that Hispanic mothers in zip codes 78203 and 78220 had respective rates of 16.0 and 11.6 per 1,000 births. The infant mortality rate in the U.S. in 2015 was 5.9 per 1,000 live births, according to the Centers for Disease Control and Prevention. In Texas, the 2015 average was 5.7. Infant mortality is defined as infants dying before their first birthday.
“Infant mortality rates – like life expectancy – is one of the overall barometers of the health of a community,” Lakey said. Infant mortality is complex, he added, and many factors contribute such as poverty, education level, and access to healthcare. Communities can improve by looking at how these contributing factors present at the neighborhood level.
Lakey said the study does not address why infant mortality rates are higher in certain communities; rather, the information gives communities the opportunity to look into certain zip codes and “concentrate efforts in those regions.”
Infant mortality prevention is the specific purpose of San Antonio Metropolitan Health District’s Healthy Start, said Kori Eberle who manages the federally funded program that provides in-home services to promote healthy pregnancies and healthy births.
The program is “geographically targeted,” Eberle explained. Healthy Start officials began looking into 78220 in 2016 when internal data suggested that certain areas on the Eastside had greater health disparities.
“We wanted to be strategic about who we were reaching out to, and began reaching out to folks with higher infant mortality rates,” Eberle said.
Through the Neighborhoods Program, a “place-based initiative” aimed at improving maternal and child health within a specific neighborhood, Metro Health works with community members to establish and promote health initiatives.
Also in 2016, Metro Health reestablished its fetal infant mortality review program, which analyzes infant deaths and creates case summaries based on maternal interviews. “We have a case review team and a community action team that work to develop strategies to address specifies struggles and develop strategies to address them,” Eberle said.
The group has been meeting since April 2016.
“…The issue[s] of infant and maternal mortality have had a lot of spotlight in recent months,” Eberle said. “We need all kinds of stakeholders looking at this to improve and target services toward [vulnerable populations].”
The UT System study calculated data from the Texas Department of State Health Services vital statistics birth and death records from 2011-14. Of the 2,455 zip codes in Texas, infant mortality rates for 842 were calculated, which accounted for 93 percent of all the births in Texas over this four-year period. The zip code level rates were calculated for communities with 400 or more births during the four years and were identified by the mother’s zip code of residence at delivery.
Fifteen of the included zip codes did not experience a single infant death in the four-year time period, whereas 59 experienced more than 1 percent of their infants dying before their first birthday.
“Texas is a very big state, and because of that we a lot of times lose the granular data that we need to make important public health decisions,” Lakey said. “County-wide data is not enough to tell you where to focus because pockets with poor outcomes are easily masked.”