06/21/04 — Death rate for children drops; infant mortality edges higher

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Death rate for children drops; infant mortality edges higher

By Phyllis Moore
Published in News on June 21, 2004 1:58 PM

The number of child fatalities in Wayne County has gone down in the last five years, while deaths from birth defects and sudden infant death syndrome have increased.

In a comparison of two five-year periods, 1992-1996 and 1998-2002, the total number of deaths for children under 18 years old went from 145 to 140.

But deaths from birth defects rose by eight, or 53 percent, and from sudden infant death syndrome, or SIDS, by four deaths, or 57 percent.

"We have more under age 1 dying now than five years ago," said Nina Silverthorne, children's services coordinator and maternity care coordinator for the county Health Department.

Between 1992 and 1996, a reported 68 babies under a year old died, as compared with 91 deaths reported between 1998 and 2002. That represents an increase of 34 percent.

Deaths from birth defects rose from 15 to 23, and rose from 7 to 11 for SIDS cases. The statistics were gathered by the county Health Department for its latest community health assessment. State-generated reports are reviewed regularly by the county Child-Fatality Prevention Team.

Ms. Silverthorne is a member of the prevention team along with representatives from other agencies, schools and the community.

She said each county in the state has a team, and Wayne County's meets every other month.

"We discuss our own personal records, reviewing cases a year after their occurrence," she said. "We look for anything that could have been done to prevent the deaths, as well as any gaps in services for the agency that provided service."

That is easier in some cases, more difficult in others. In the situation of a traffic accident, for example, research could show whether there has been a recurrent problem at a particular intersection.

If there is a trend, such as an increase in drownings at swimming pools, the state would be notified and the numbers combined with results from other areas.

More often, though, the cases are unforeseeable and unfortunate losses for families. Many are deaths of children born prematurely or related to birth defects.

"We have been concerned about birth defects and looking at making sure moms get as much prenatal care as possible," Ms. Silverthorne said.

She suggested that advancements in medicine have prolonged the lives of babies that would have been miscarriages. "Medicine has come so far in keeping extremely premature children alive," she said, but those same premature babies also face a greater risk of dying than a child born a full term.

While deaths of babies have climbed in recent years, in cases of traffic accidents, fire, drowning and homicide, they have declined by 20. In the last five years, there was a 40 percent drop in the number of deaths in those aged 15 to 17 years old.

Some of these have been attributed to the graduated-license law for teen-agers, promoted by the state Child-Fatality Prevention Team and passed in 1997.

According to the statistics, there were 18 car-related deaths between 1992 and 1996 versus 13 since the law has been enacted.

The Child Fatality Prevention Team does not keep records and does not contact families of the deceased. It simply goes by the information sent from the state and uses it to make any recommendations.

Recommendations, Ms. Silverthorne said, may be requests or suggestions to agencies or to state legislators.

She said that when the county team was organized in the mid-1990s, it might have had a dozen cases to review each quarter. The numbers have dropped to an average of three or four.

That does not mean the task is pleasant, though.

"It's very depressing," she said, "especially the young people's deaths. It's very heartbreaking when you realize some of the heartbreak the family is going through.

"If you can spare some of them going through this, it's worth it."

She said community members, especially parents who have lost a child, are encouraged to serve on the team.

"We could always use more," she said. "There might be some parents who would be interested in doing something in memory of their child."

The statewide child-fatality prevention system was established by the N.C. General Assembly in 1995. Its purpose is to assess records of all deaths of children in the state from birth to age 18 in order to understand the causes, identify any gaps or deficiencies in the delivery of services to children and their families by public agencies, and to make or change laws, rules and policies to prevent deaths.