Healthy People 2020: Infant Mortality

According to the World Health Organisation [WHO] (2014) pre-term babies are at increased risk of illness, disability and death. It also states that globally 15 million babies are born pre-term and the figures are rising. In England and Wales during 2012 7.3% of live births were pre-term under 37 weeks nearly 85% of all babies born prematurely will have a very low birth weight (Office for National Statistics, 2012). Pre-term birth is associated with respiratory complications and lung disease, long-tern neurological damage and problems with bowel function (Henderson & Macdonald, 2011). Neonatal services provide care to babies who are born prematurely or are ill and require specialist care. It is seen that sixty per cent of infant deaths occur in the neonatal period (DH,

Infant mortality is and has been an issue for a very long time. It can be defined as the rate of deaths that happen before a child’s first birthday (Centers for Disease Control and Prevention, 2013). A consequence of infant mortality is the mental health of the family that must deal with the death of a child; when one loses a child very early it can be difficult to cope with and the parents might develop depression. There are several risk factors for infant mortality, including congenital abnormalities, being born preterm, having a low birth weight, and lower socioeconomic status of the child’s family. Furthermore, a problem such as this is contingent upon access to health care; third-world countries and impoverished areas might have little to no access to health care, therefore, increasing the risk of complications with a pregnancy. A mother must have prenatal care to support good health for the baby.

A baby deserves to experience and witness life’s beauties. If the mother tragically loses her life during childbirth, it is well worth it.

Maternal mortality represents more than the loss of lives for individual women, as it also reflects the larger value and prioritization of women 's health and threatens the health and survival of families, young children, and even the communities in which they live (Royston and Armstrong, 1989). Maternal mortality is unacceptably high (WHO, 2015b). Globally, approximately 830 women die every day from pregnancy- or childbirth-related complications (ibid.). The causes of maternal mortality are predominately preventable and can be classified into three fundamental causes: (1) medical - consisting of direct medical problems and pre-existent/coexistent medical problems that are aggravated by pregnancy, (2) underlying - social and legal conditions, and (3) health systems laws and policies that address availability, accessibility, and quality of reproductive health services (PHP et al, 2011).

Regardless of healthcare and medical advances, birth outcome disparities continue to exist in the United States. In 2014, 1 out of 10 infant births were premature, correlating to over 380,000 infants born prematurely (Health 2016). The current national average for infant births before 37 weeks is 9.6% (Services 2010). Premature birth is identified as a birth that occurs before the 37- week gestation. During the preterm period, infants are placed at a high risk of death and developing disabilities that may cause permanent handicap. Mothers that give birth preterm may partake in risky behaviors such as smoking and drug usage, lack proper nutrition, and are burdened financially. Maternal education intervention programs centered around the Health Belief Model may have a positive impact on maternal care and prevent premature birth.

Premature birth is an important public health priority in terms of health of women and infants. Every year an estimated 15 million preterm babies are born and this number is still rising (WHO, 2015).In 2014, 1 of every 10 babies born in United States were premature and black infants were 50% more likely to be born premature than white, Hispanic and Asian/Pacific islander infants (CDC,2015). Almost 1 million children die each year due to complications of premature birth (WHO, 2015). Major survivors face lifelong disabilities like learning disabilities, hearing, visual, feeding, digestive, breathing and respiratory problems (CDC, 2015) and low birth weight (March of Dimes, 2014). A major challenge in decreasing the rate of preterm birth is

Having a baby die, whether in the womb or during birth can be the most tragic and heart breaking experience parents and nurses’ face. A nurse’s knowledge of the best way to respond to each unique situation of perinatal loss to help the mother and family cope effectively is critical to provide a holistic family centered care. Perinatal death is defined as the combination of stillbirth and neonatal fatalities in the first week of life (WHO). Nurses

“Compared with European Americans, African American infants experience disproportionately high rates of low birth weight (LBW) and preterm delivery and are more than twice as likely to die during their 1st year of life”(Giscombé, C. L., & Lobel, M., 2005). The infant mortality rate for African Americans is 13.7 deaths per 1000 live births, more than twice the rate (5.7) for White Americans in the U.S. (Kung, Hoyert, Xu, & Murphy, 2008). A lot of the racial disparity in infant mortality can be explained by low birthweight and preterm delivery, which are also disproportionately and often experienced by African Americans (Martin et al., 2007).

Healthy People 2020 initiative began in 1979 is a joint initiative of the Department of Health, Human Services, and other federal agencies to create a pubic health prevention framework identifying the most significant and preventable threats to health and facilitating methods and guidelines to avoid or minimize risks of these.

In the Common Wealth Fund’s most recent report of Mirror, Mirror on the Wall, despite the fact the US Health care system has the highest healthcare per capita expenditure and the highest proportion of specialists; it consistently has an overall ranking of last, in comparison to other industrialized nations in terms of health care efficiency, equity, quality, access, and healthy lives (Davis, Stremikis, Squires & Schoen, 2014). Healthy lives measured by mortality amenable to health care (deaths prevented with timely and effective care), healthy life expectancy and infant mortality, illustrates that a country is ensuring individuals live long and flourishing lives (Davis, Stremikis, Squires & Schoen, 2014). Healthy People 2020 which was launched

Discuss disparities related to ethnic and cultural groups relative to low birth weight infants and preterm births. Describe the impact of extremely low birth weight babies on the family and on the community (short-term and long-term, including economic considerations, on-going care considerations, and co-morbidities associated with prematurity). Identify at least one support service within your community for preterm infants and their family. Provide the link for your colleagues to view. Does the service adequately address needs of this population? Explain your answer.

Centre for Maternal and Child Enquiries (CMACE) (2011) Saving mothers’ lives; reviewing maternal deaths to make motherhood safer: 2006-2008. BJOG 18(1): 1-203. London. Blackwell Synergy.

I spent the past week reviewing all the data I have collected to this point. The data and health needs reported in Healthy People 2020, as well as the epidemiological and community data I collected, convey consistent themes. The HP 2020 topics of injury and violence prevention, hearing and communication disorders, oral health and access to health services all appear to be topics of concern and are identified health needs of the community I am targeting. With epidemiological data showing the rates of autism climbing at steady levels, the need for an increase awareness and planned interventions involving these health topics will be essential to meet the objectives established by the federal government.

The U.S. infant mortality rate is 5.7 per 1000 births and 1.5 in Canada although has declined over the past several decades (O'Neill & O'Neill, 2007). Low-birth weight babies have a better chance at survival in the U.S. than in Canada due to advances in medical technology and expenditures on intensive care units (O'Neill & O'Neill, 2007). The reason there are more infant mortality rates in the U.S. is because there are more infants born weighing very little than compared to Canada.

In his article, "Why are so many U.S. women dying during childbirth?", Munz (2012) pointed out that U.S. is experiencing a rise in maternal mortality. It has doubled for the last 25 years and the experts are uncertain about the increase. Experts are not entirely clear for the rise in the maternal deaths in the U.S., but there are some aspects that may be link to this.