Infant Mortality On the Rise

November 7, 2023

By Courtney Wise

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‘We shouldn’t have babies dying in the first year of life’ – but we do, and in rising numbers

After 20 years of overall decline, the death rate of babies in the US rose 3% from 2021 to 2022, said the Centers for Disease Control and Prevention in a report published Wednesday. Indigenous infants, babies born to white women, babies born to women ages 25 to 29, infant boys, and preterm babies had the sharpest increase in deaths. Experts cannot pinpoint exactly what caused the increase, but they speculate that lack of prenatal care, complications during pregnancy, bacterial infections contracted during birth and stress are among the reasons.

The change is “disturbing,” no matter what prompted the shift, neonatologist Eric Eichenwalk told the Associated Press. The US infant death rate is double that of many developed countries, according to the Wall Street Journal, rising with US maternal mortality, too, even as global baby death rates fall.

“The US is falling behind on a basic indicator of how well societies treat people,” Arjumand Siddiqi, a population health researcher at the University of Toronto, told the WSJ. “In a country as well-resourced as the US, with as much medical technology and so on, we shouldn’t have babies dying in the first year of life. That should be super rare, and it’s not.” March of Dimes chief executive Elizabeth Cherot added that the data “underscores that our failure to better support moms before, during, and after birth is among the factors contributing to poor infant health outcomes.”

ICYMI yesterday, see our story on how Black doulas are helping Black moms “feel seen and heard,” cross-published by USA Today and by CapitalB.

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Dr. Barbara Greenberg on dealing with adult children who cut off a sibling

Caregiving can bring out the best in many families, but the added stress and worry can also ignite old resentments and jealousy. In a column for Psychology Today, clinical psychologist Barbara Greenberg recounts the story of a mother who was diagnosed with breast cancer two years after her husband died – and although her children were attentive and helpful, they began fighting with each other.

The trouble started with her chemotherapy sessions. She was grateful her adult daughters took turns accompanying her to the infusions, while her son, who traveled a lot and worked long hours, visited her at home. However, while in recovery, she was despondent to find that her oldest daughter had cut off her brother, complaining that he had not come to the infusions. When her mother tried to reason with her, her oldest daughter accused her of always favoring her son. Meanwhile, the other sister refused take sides. Find out the advice Dr. Greenberg gave to the distressed mom.

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New CMS rules offers some gains for mental health coverage – and some losses – for providers

As we shared in a recent MindSite Daily Newsletter, Medicare will soon cover mental health services provided by therapists and other licensed mental health providers after decades of limiting reimbursements to psychiatrists, psychologists, licensed clinical social workers, and psychiatric nurses. Come January, that one change will enable 400,000 additional mental health professionals — a whopping 40 percent of the workforce — to treat patients insured by Medicare, KFF News reported. In addition, Medicare will allow up to 19 hours per week of intensive outpatient mental health care, increasing peer support for people with severe mental illness and making mobile crisis services more available to housed and unhoused people. But, now that the Centers for Medicare & Medicaid Services (CMS) have finalized updates to their physician fee schedule for 2024, providers are vexed by cuts in payment rates the agency is offering, they told MedCity News.

According to the physician fee schedule from CMS for 2024, Medicare is lowering by 3.4% the s0-called fee “conversion factor” – a complicated formula that sets rates based on geography and other factors – contributing to an overall cut of 1.25% in physician fees. The decline was criticized by provider groups who says doctors and other providers are already underpaid by Medicare, driving growing numbers to refuse to participate in the program. Already, nearly half of eligible psychiatrists and psychologists refuse to accept Medicare due to low payments and bureaucratic frustrations.

“Access to care is being threatened,” said American Medical Association President Jesse Ehrenfeld. “The declining revenues in the face of steep cost increases disproportionately affect small, independent, and rural physician practices, as well as those treating low-income or other historically minoritized or marginalized patient communities.” Leaders of the Medical Group Management Association concurred, saying that the “inadequate Medicare payments” make it difficult for medical practices to remain financially solvent. It will require Congressional action to make real changes to the compensation system. Good luck with that.

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In other news…

Courtney B. Vance writes book on Black men’s mental health: He’s best known for captivating audiences on film and stage, but Courtney B. Vance is now an author, too. This time, he’s teamed up with psychologist Robin D. Smith to write The Invisible Ache: Black Men Identifying Their Pain and Reclaiming Their Power, out today. The book – part memoir, part psychology – is aimed at Black men and their silent struggles with mental health. It offers practical tools that Vance hopes will offer men hope and support in the event of mental despair. Having lost his father and godson to suicide, Vance told People magazine his hope for the book is to bring even just “one person from the brink to say, ‘If he can, where he was, begin to do the work, to take the steps, then maybe I can.’” 

Training barbers, bartenders and divorce attorneys as counselors could help prevent gun suicides, according to a recent article in Scientific American. “Historically, suicide prevention has focused on the mental health risk factors that might lead an individual to want to die. But while such an approach is intuitively appealing, it isn’t working,” writes Sara Novak. “That’s why researchers and suicide prevention advocates have taken a new approach: making the surrounding environment safer so that those at risk (whether they know it or not) are less likely to die by suicide.” MindSite News has previously written about training barbers to be counselors in The Confess Project, and an expert interviewed by Scientific American makes the case that bartenders and divorce attorney could also serve as counselors, even educating people about safe gun storage in times of despair.

So many Black children and adolescents are visiting ERs for mental health concerns that it has become “a public health crisis.” Data reported by the CDC in late October showed that Black youth had the highest rate of mental health-related emergency room visits. It didn’t surprise Ashley Maxie-Moreman, a DC-based clinical psychologist who studies the impact of racism on Black youth, particularly in digital spaces. Online communities are just as susceptible to racism and discrimination as the ones experienced in-person. “Racial discrimination is really harmful for our kiddos,” Maxie-Moreman told Capital B News. Suicide attempts among Black youth have skyrocketed by 80 percent over the past 30 years. And Black children are less likely to have access to therapy and to stop using it more frequently, said psychiatrist Amanda Calhoun. Her young Black clients often report having tried therapy before seeing her, but say they stopped going after feeling dismissed, discriminated against, or misunderstood by their previous clinician. 

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.