Report finds state's infant mortality rate on rise

By Janis L. Magin
Associated Press

While infant mortality was on the decline during the 1990s nationally, Hawai'i's rate of infant deaths rose in the past six years to rank the state 37th in the nation in the Kids Count 2003 Data Book released today.

Kids Count, a project of the Baltimore-based Annie E. Casey Foundation, ranks indicators including the percentage of low-birthweight babies, a state's child death rate, the rate of teen deaths, teen birth rates, percentage of children living in poverty and the percentage of children living in one-parent households to gauge the general welfare of children in the 50 states and the District of Columbia.

Teen death rate low

Hawai'i ranked 22nd overall for child well-being, and 19th based on per capita income. The state was ranked second in the nation for a low rate of teen deaths by accident, homicide and suicide, and was third in the nation for the death rate of children up to age 14 and for the percent of teenagers who have dropped out of high school.

"I think this kind of a report, it doesn't tell us the whys of anything," said Marcia Hartsock of the Hawai'i Kids Count program at the University of Hawai'i's Center on the Family. "But it does tell us whether we're committing the resources to our children so that they can succeed."

In Hawai'i, infant mortality rates — the number of children who die before their first birthdays compared to the number of live births in a particular year — were relatively low during the 90s, but started to rise in 1997.

The lowest rate in the past 20 years was in 1996, when it was 5.8 deaths per 1,000 births, said Cheryl Price, a child health epidemiologist with the Department of Health.

Population factor

Price, who has charted infant mortality for the past decade, says the latest numbers may be misleading because of Hawai'i's relatively small population. Because so few babies are born in Hawai'i, compared to larger states, the deaths of as few as 10 children can skew the state's rate, she said.

Despite that, the rate has remained statistically steady over the past 10 years, she said.

Regardless, state House Health Committee Chairman Dennis Arakaki, one of 33 lawmakers in the Legislature's "Keiki Caucus," said the infant mortality rate reflects the state's economy.

"I guess you can surmise that when the economy goes bad it's children and families that suffer," said Arakaki, D-30th (Moanalua, Kalihi Valley, 'Alewa).

Known risk factors

The leading causes of infant mortality are congenital malformations, pre-term delivery and SIDS — sudden infant death syndrome — with most deaths occurring in infants less than 28 days old, Price said.

A number of risk factors, including smoking and lack of prenatal care, are also associated with infant mortality, she said.

Arakaki pointed to cutbacks to health and human service programs that stress preventative care, including prenatal care.

The report also found:

• The state ranked 25th in the nation for the percentage of low-birthweight babies with 7.5 percent, slightly under the national rate of 7.6 percent.
• Hawai'i's teen birth rate, the number of births per 1,000 girls aged 15 to 17, fell to 23 per 1,000 in 2000, from 32 in 1990, ranking Hawai'i at 23rd in the nation; nationally the rate was 27.