Infant Death Rates Bear Close Scrutiny : * Emphasis on Maternal Health Care Could Pay Off Big

Traditionally, Orange County has compared favorably to the nation and the state in its infant mortality rate, and that is still the case. But figures released last week indicate that the county’s rate rose in 1989. It’s a little early to tell if this is a statistical blip or cause for alarm, but any increase in infant deaths should not be ignored.

Especially at these times of budget cutbacks in health care for the poor, infant death rates can provide a compelling guide to what must be done to preserve the good health of our youngest residents. That’s why it’s important to get these statistics quickly, and why Board of Supervisors Chairman Gaddi H. Vasquez expressed concern about state delays in providing them to Orange County. The state should do better on this. Still, it doesn’t take statistics but just common sense to see that putting a stronger emphasis on pregnancy and maternal health care could prevent more costly health problems or even infant deaths.

According to the Orange County Health Care Agency, 1989 figures indicated that there were 7.3 deaths per 1,000 live births in the county, compared to 6.8 deaths per 1,000 the previous year. Since 1981, rates have risen as high as 9.3 per 1,000 in 1982 and have fallen to as low as 6.5 per 1,000 in 1986. Nationwide, the infant death rate was 9.9 per 1,000 births in 1988 and, in that same year, California’s was 8.6.

Orange County’s figures bring to light changing demographics and also reveal that infant death rates are tied to more than just poverty. For example, in 1989, there were 19,111 Latino births, just 1,639 fewer than Anglo births. And, although Latinos as a group are on a lower economic rung in the county, their infant death rates were substantially less than all other ethnic groups, including Anglos. Experts say that’s because Latino women have stronger family ties and better health habits. (One of the down sides of assimilation is that these attributes seem to diminish in later generations.)

To demonstrate how statistics can be twisted, however, health officials worry that comparatively low infant death rates among Latinos could be used to justify a lack of urgency about providing prenatal care to impoverished women. That would be unfortunate. In 1989, more than 40% of Latino women did not receive prenatal care in their first trimester of pregnancy. Nor were they alone in this neglect: 45% of teen-age mothers also went without.

Health professionals who work with poor women search for ways to provide better access to care but are hampered by budget cutbacks at all levels of government. In Orange County, there are a few encouraging signs of progress, including two birthing centers being funded by Proposition 99, the cigarette tax initiative. UCI Medical Center will open its $1-million facility later this year and Western Medical Center-Anaheim will open a $1.3-million facility in 1992. That should help take a load off local hospitals, particularly UCI Medical Center, that have been overwhelmed with births in recent years under the state’s Medi-Cal program for poor people.

Other good news: St. Jude Hospital and Rehabilitation Center in Fullerton soon will have in operation a mobile clinic that will provide Medi-Cal services for up to 240 pregnant women in North County.

But much more is needed.

Infant death rates are one of the gauges of the health not just of babies but of society. They reflect Orange County’s commitment to quality of life for all its residents. That’s why these rates bear close watching, and why the county needs to find the will and the way to improve prenatal health care.