There’s a long list of problems to tackle for a public health official who’s committed to making Maine one of the healthiest states in the nation in which to live and raise a family.
But confronting a major public health problem first requires acknowledgment. And although the evidence is overwhelming that Maine today has a higher rate of infant deaths than it did less than a decade ago and that Maine has been the only state to see its infant mortality rate rise in the past decade, Maine’s top public health official hasn’t quite reached the acknowledgment stage.
Sheryl Peavey, the chief operating officer of the Maine Center for Disease Control and Prevention, denied to lawmakers late last month that Maine’s infant mortality has been on the rise. Peavey was speaking to the Legislature’s Health and Human Services Committee, attempting to make the case that her and her agency’s moves to leave more than half of the state’s public health nurse positions vacant won’t leave Maine unprepared to confront a public health crisis — and that the cuts haven’t led to a higher infant mortality rate.
“We don’t have a higher infant mortality rate, and we do have fewer nurses,” Peavey said April 26.
When Gov. Paul LePage took office in 2011, Maine employed about 50 full-time public health nurses spread across the state whose responsibilities included containing infectious disease outbreaks and improving the health of new moms and babies.
But with only about 20 nurses in the field today, medical providers across the state have reported that public health nurses are generally unavailable when they want to refer new mothers and babies for home visits. Decades of research have shown that sending a nurse into a new parent’s home is associated with a range of positive outcomes, including reduced likelihood of infant deaths.
So public health nurses could form a critical part of Maine’s response to a rising rate of infant deaths. But to Peavey, Maine apparently doesn’t have an infant mortality problem.
Tracking infant mortality is “one of our priorities as a department and for us to be able to make sure, are we on the right track? Are we doing what we need to be doing?” she said April 26. “Is there suddenly a skyrocketing number? There isn’t, from a statewide perspective.”
But the evidence is irrefutable that Maine has seen a long-term rise in infant mortality.
In 1996 and again in 2002, Maine posted the nation’s lowest infant mortality rate — for every 1,000 births in those years, 4.36 and 4.28 babies respectively died in their first year. But by 2014, according to the U.S. CDC, Maine’s ranking had dropped to 37th lowest: 6.69 infants died in their first year for every 1,000 births. Among white babies, Maine’s infant death rate was lower than only two states — Oklahoma and West Virginia.
The Bangor Daily News’ Maine Focus team reported last summer that Maine was the only state to see its infant death rate rise in the decade between 2005 and 2014, compared with the previous decade, 1995-2004. Nearly every Maine county today sees a greater portion of its newborns die than in the mid-1990s, according to long-term averages compiled by the Maine Children’s Alliance.
The Maine CDC has in the past acknowledged the state’s rising infant mortality rate, contrary to Peavey’s assessment. “Maine once had one of the lowest infant mortality rates in the U.S., but it is now one of the highest,” the CDC wrote last year in a federal grant application. And Dr. Chris Pezzullo, the state health officer, acknowledged the rise in January in announcing the first meeting of a newly reconstituted panel charged with exploring the reasons behind the trend. “Maine has experienced a concerning increase in its infant mortality rate over the past four years,” he wrote in a letter to panel members.
To be sure, Maine’s infant mortality rate peaked in 2013, when it was eighth highest in the nation, and it fell slightly in 2014 and 2015, but that doesn’t change Maine’s long-term trend of increased infant mortality, the fact that Maine now exceeds the national average, and that Maine was the only state to see its infant mortality rate rise over the past two decades.
The Legislature’s Health and Human Services Committee will take up a handful of bills later this week that could address Maine’s high infant mortality, including a bill to restore the state’s corps of public health nurses.
Lawmakers should get behind public health policies that respond to reality — as disappointing as it is.