Racial Discrepancies in Child Mortality within a Southern County-Parish

Background: Maternal and infant health outcomes are known to be impacted by racial disparities and community health access at local, state, and national levels. Interdisciplinary prevention services (such as child welfare, maternal healthcare, early childhood services, etc.) have consistently indicated overrepresentation of Black families, specifically regarding infant and maternal deaths related to pregnancy complications. There are known programs to decrease infant mortality, but they are not consistently implemented. And mothers of minority status maintain a heightened risk for experiencing health disparities. Thus, an exploration of parish-wide child mortality rates will lead to improvement in preventive services for minority mothers and children.

Child welfare practices identify the most vulnerable children susceptible to child abuse, neglect, or fatality as being ages 0-5 years old. Prevention policies further identifies the need for improved practice and advocacy for children ages 0-5 years old. Therefore, this study also identifies the need for age-specific child welfare interventions.

Methods: This study examines the variation in child mortality within a Southern county-parish. With collaboration between the local coroner’s office and two universities, data were obtained for child deaths aged 0-10 years old and between the years 2010-2022. Cases with active court proceedings were excluded by the coroner’s office. Data were compiled exclusively from a single parish with over five major hospital systems. Exploratory analysis of child deaths (n = 1,276) was complete to examine variations in age of death, year of death, type of death, gender, and racial composition. A chi-square test was utilized to determine the expected percentages for infant deaths per year between races.

Results: Descriptive statistics identify most child deaths being at age 0 (n = 1,111), with a decrease in deaths per age. Ages 6-10 each included less than one death per year, on average, as compared to the ages 5 and below. Black children comprised 75% of all deaths recorded while 18% were recorded as White. The data identified 688 deaths (54.4%) as male, 557 deaths (44%) as female, and 19 deaths (1.5%) as missing sex. From the chi-square analysis, the years of 2014, 2017, and 2020 found differences in expected deaths and actual deaths for Black infants. Additionally, analysis of death reasons identified significant numbers for prematurity (n = 403) and fetal demise (n = 320).

Implications: Education and prevention services are insufficient to address racial disparities in infant mortality. Changes to infant-specific interdisciplinary prevention services are necessary to address the racial disparities in infant mortality. Despite these percentages being present throughout the state, limited preventive services have been initiated to address the racial disparities. Additionally, sufficient understanding of household locations is diminished as there are no zip codes or addresses associated to each death. Location of child deaths would specify the areas where preventive services are most needed.