Babies in midsize Kansas counties were more likely to die before their first birthdays than those in counties with larger or smaller populations, according to the 2016 Kids Count report.
The annual report, produced by the Annie E. Casey Foundation, compares states and counties on a variety of measures related to children’s health, financial well-being and educational prospects. In some cases, the most recent data was from 2015, while in others it was from 2014.
Statewide, infant mortality fell from 6.2 deaths for every 1,000 live births in 2011 to 5.9 deaths in 2015. Some areas continued to struggle with persistently high rates, however.
About 7.8 babies died for every 1,000 live births in “densely settled rural” counties in Kansas, which is more than 30 percent higher than the statewide average of 5.9 deaths, according to the report. Densely settled rural areas have 20 to 40 residents per square mile and include counties like Doniphan, Cherokee, Sumner and Finney.
Babies in “frontier” areas, which have fewer than six residents per square mile, were the most likely to survive until their first birthday. Urban-born babies were at higher risk than those born in frontier areas but still had lower risk than those in dense rural areas.
Christy Schunn, executive director of the Kansas Infant Death and SIDS Network, says the rate in dense rural areas could be higher because of the small number of births in those counties. It also could reflect higher poverty rates or a lack of health education and resources, she says.
“There are some places in southeast Kansas where they don’t have a place to go buy a crib,” she says. “Maybe they’re getting prenatal care, but there’s a barrier to us getting the Safe Sleep program there.”
The Centers for Disease Control and Prevention estimates about 15 percent of infant deaths result from an unsafe sleeping environment, such as sharing a bed with a parent or using a soft mattress. Babies also are at risk if mothers smoked or used other drugs during pregnancy. Some also die as the result of medical conditions, accidents or abuse.
Increasing access to early care
Infant mortality rates can vary dramatically from year to year, but some counties have tracked consistently in recent years. For example, the infant mortality rate was higher than the statewide rate in Ford County, a dense rural county, four of the last five years.
Angela Sowers, administrator at the Ford County Health Department, says while she isn’t certain why that rate is higher, the area’s large immigrant population may be a factor. Some women aren’t aware of prenatal care or aren’t sure where to get it, particularly if they don’t speak English fluently, she says.
“Some of the population we see might not even seek prenatal care until the last trimester,” she says.
The health department has outreach programs to try to find women who don’t know where to go for care and offers translation services and free visits to those who qualify, Sowers says. They also use other programs, like nutrition assistance, to keep the families connected to the health care system after a baby is born, she says.
Beth Brown, health officer for Jefferson County, another dense rural area, says the health department there noticed the infant mortality rate was rising and is working with the Kansas Department of Health and Environment to determine the reason.
The Jefferson County Health Department also has worked to provide information to pregnant women about the importance of early prenatal care and breastfeeding, Brown says. It also is helping low-income women to sign up for Medicaid coverage and the Women, Infants and Children nutrition program, she says.
“Obviously we’re concerned with the steady increase,” she says.
Different counties, different threats
Kansas teens face different health dangers based on where they live, according to the Kids Count report. Teens in rural and frontier areas were more likely to die as a result of traffic wrecks, suicide or homicide, according to the Kids Count data.
Overall, however, Kansas teens were less likely to die from violence or a wreck in 2014 than in 2010, possibly reflecting a nationwide downward trend in traffic deaths.
Urban children were the most likely to be hospitalized for mental health issues, though it isn’t clear if they were more likely to be ill or just treated more aggressively. The rate of mental health hospitalizations rose from 2011 to 2015.
Urban kids were less likely to be uninsured or live in poverty than children in less populated areas, but frontier children were the most likely to have all of their immunizations. All three measures — for insurance, poverty and immunization — improved over the previous four years.
About 17.2 percent of Kansas children were living below the poverty line in 2015, down from about 21 percent in 2011. The percentage of children without health insurance also fell from about 6.4 percent to 5.1 percent.
Meg Wingerter is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team. You can reach her on Twitter @meganhartMC