Infant Mortality In Worcester Steady, But Racism Still A Main Problem

WORCESTER, MA — New data released this week by the Worcester Healthy Baby Collaborative show infant mortality rates continuing a downward trend in Worcester, but key barriers remain to bringing the rate closer to the statewide average.

UMass Chan professor Dr. Mukti Kulkarni presented the newest figures through 2021 to the Worcester Board of Health on Monday. The city's infant mortality rate — which tracks deaths between birth and age 1 — was about 5.1 deaths per 1,000 live births at the end of 2021 compared to the statewide rate of 3.9 per 1,000, Kulkarni's presentation showed.

While still above the state figure, Kulkarni said the city's rate has reached into the high teens in previous years, and was between 8 and 9 per 1,000 in the 1990s. Worcester once had the highest rate in the state, leading Dr. Leonard Morse to create the Worcester Healthy Baby Collaborative in 1996.

Of the infants who died in 2021, Kulkarni said, all but one were born to people from outside the 50 U.S. states, signaling a possible barrier for new migrants learning about local services. All the deaths were due to either extreme prematurity or congenital anomalies. None of the deaths were linked to substance abuse.

But infant mortality in Worcester is higher when broken out by race. According to Kulkarni's data, Black women had the highest infant mortality (7.5) rate followed by Hispanic women (5.1). A category that includes white, Asian and Indigenous people tracks more in line with the state average of 3.8 per 1,000.

"Overall, disparities are narrowing over time. But Worcester's Black and Hispanic infant mortality rates still remain notably high," Kulkarni said.

Dr. Sara Shields, a physician who works at the Family Health Center of Worcester, told the health board that racism is one major barrier to reducing Worcester's infant mortality rate further. Black mothers nationwide have experienced a glaringly high maternal death rate since the early 1990s, according to the Centers for Disease Control and Prevention.

"One of the biggest risk factors we need to name clearly is racism," she said. "This is about people's experience of racism in our society."

The Worcester Healthy Baby Collaborative has tried to ameliorate racism in local healthcare facilities by providing diversity and equity training for health providers.

Shields said Worcester's infant mortality rate fell over the past two decades in large part due to a federally-funded program called the Healthy Start Initiative. The program funded postpartum case management for up to two years. Federal funding ran out in 2012, but the Worcester Community Health Center has kept it going ever since by stringing together other grants, Shields said.

"We're down a case manager right now and facing a pretty significant growing population with a lot of needs in terms of maternal-infant health among the Haitian, Afghan immigrants and some Brazilian immigrants as well," she said.

The healthy baby collaborative sources its data from city death certificates, and records from the UMass Memorial system and St. Vincent's Hospital. For context, Kulkarni said the world's lowest infant mortality rate is 1.5 per 1,000 in Singapore, and highest in Afghanistan at about 100 per 1,000.