September is National Infant Mortality Awareness Month. This is an important awareness campaign, and on September 23rd, the Senate passed a Resolution supporting its values and goals. However, you may be wondering what it has to do with Child Welfare policy. Well, I’m glad you asked!
First, some background. This observance was established by the National Healthy Start Association, which administers the Healthy Start Initiative. This Initiative began as a pilot program in 1991, and in 2008 President George W. Bush reauthorized the law through 2013. The initiative focuses on supporting efforts to reduce infant mortality rates (number of deaths per 1,000 live births before the 1st birthday) for the most vulnerable children.
Now, the data. This focus on the most vulnerable children is partly due to disparities between Caucasian and African American children in U.S. infant mortality rates. According to the CDC, in 2007 the overall infant mortality rate for the U.S. was 6.75. For White infants the rate was 5.64, but for Black infants it was 13.24. Additionally, adolescent births have even higher infant mortality rates. According to 2006 data, the overall U.S. was at 9.8, White teens were at 8.3, and Black teens stood at 13.94. In terms of actual rates of teen pregnancy (live births per 1,000 to mothers age 15-17), in 2009 it was 20.1 for the U.S. overall, 11.0 for White teens, and 32.1 for Black teens.
The disparities persist, and vulnerability is also associated with low socioeconomic status, another category disproportionately represented by African American families.
These numbers echo many of the same disparities seen in the larger Health Care system, some of which spill over into the Child Welfare system. Teen pregnancy rates carry implications for infant mortality and child welfare programs because children aging out of foster care have a higher probability of teen pregnancy. Due to the complicated nature of parental authority within the foster care system, many infants born to teens in out of home placement become involved with child protection. The compounding factor of racial disparities within these systems only makes the issue more urgent.
The response. On September 15th, H.R. 2954: Health Equity and Accountability Act of 2011 was introduced by Barbara Lee

[D-CA9] and carries 71 cosponsors. This bill is packed full and aims at addressing racial disparities within the Health Care system. H.R. 2954 outlines plans for promoting the development of culturally appropriate programming within systems serving large numbers of at-risk youth. The bill specifically indicates the need for programming within the foster care system and emphasizes a focus on racial groups that are disproportionately affected by health issues. Some highlights include:

  • Requirements for programming directed at reducing teen pregnancies.
  • The provision of grants for further research on best practices in reducing teen pregnancy, teenage dating violence, and improving healthy relationships.
  • Developing a community mental health safety net.

Given the daunting nature of the data, how do you think legislation promoting coordinated services and targeting racial and ethnic minority groups will impact the Child Welfare system and infant mortality rates? Are there any implications not being considered? How else could these disparities be addressed?