MICHEL MARTIN, HOST:
We'd like to turn now to a disturbing health crisis closer to home. We want to talk about the large number of deaths of children in Detroit. According to a recent report by The Detroit News, it has the highest rate of infant and child mortality of major American cities. It's even higher than in some developing nations. And we wanted to know why so we called Karen Bouffard. She is the health care writer for The Detroit News. She's been reporting on this. Also with us is social worker Paris Rutledge. She is support coordinator for the Infant Mortality Program at St. John Health System in Detroit. Welcome to you both. Thank you for joining us.
KAREN BOUFFARD: It's good to be here.
>>RUTLEDGE. Thank you so much. It's good to be here.
MARTIN: So, Karen, let me start with you. You wrote that the number of deaths might not seem large because the population of the city has shrunk - I mean, a lot of people have moved away - but the rate of infant deaths to live birth is as high as ever. Can you tell us about that?
BOUFFARD: Yes, well, the state has been working and trying to reduce the infant mortality rate on a statewide basis, but when you look at what's been happening in the city of Detroit, it's really been reduced very little since the start of, you know, the last decade in 2000. What you see also is that the gains that had been made - there had been a little bit of a decreased prior to 2006 - but the rate increased again during the recession.
MARTIN: And you reported that infant mortality is the number one killer of Detroit children, followed by violence. So I just want to talk about those separately. To start with infant mortality, Karen, you were saying that Detroit also has more babies born to moms who are under 20 and to single women than in any other major American city. Why would those be factors?
BOUFFARD: Well, when you have babies born to women who aren't married, they often just don't have a very - a whole lot of support at home. And without an additional income, they also tend to be living in a great deal of poverty. Detroit has the most children living in extreme poverty in the United States - 32 percent. A lot of these moms are also younger than 20. So you have teenage mothers who are, you know, living in extreme poverty. They don't have a support person with them. And, also, many of them become pregnant in not such great health because, you know, many aren't insured. So it's a constellation of risk factors that contribute to the problem. Detroit also has the most teens between 16 and 19 that are neither in school nor working.
MARTIN: Paris, let's hear from you on this because you work with parents both during pregnancy and after the baby is born. Are there some common issues that you see that maybe other people may not realize that might be a factor here?
PARIS RUTLEDGE: Well, as Karen said, you know, a lot of the problem is that they're teens - they don't have a lot of support. Usually, the 15 and under age group, the families, you know, take them and support them. But that 16 and up, the group that naturally in any environment would have - begin to have potential issues with their mom that, you know, a young lady growing up and having issues with their mom. So a lot of those young ladies move out or attempt to move out on their own and it's not as easy as it appears to be when you're at home with your parents and all of the bills are being paid, suddenly all of this falls on you. And, you know, there have been quite a few cuts in our welfare system so moms are struggling out there to get the resources that they need.
MARTIN: And, Karen, I think now we also have to talk about the whole question of violence. We're not just talking about babies at risk. You spoke with a woman named Sunseara Hall, who lost her 12-year-old son in a shooting. And this is what she told you about that day.
(SOUNDBITE OF INTERVIEW)
SUNSEARA HALL: All the kids were outside on the porch. I had just pulled back up in the driveway and my friend had said, isn't that the car? And I looked and that's when I seen the car ran past. By the time I yelled get in the house - it seemed like it was just that quick - he was back in front of the house and he was shooting.
MARTIN: Karen, is violence seen as a public health issue there?
BOUFFARD: I don't think that it always is seen as a public health issue. One thing I'd like to point out is that, you know, under the judicial system a lot of these late-teens, you know, kids that are 16, 17 and 18, aren't considered children. And so you have, you know, a criminal justice system that views them as adults. And I think sometimes that kind of falls over into public perceptions. And this is part of why I wanted to look at the 0 through 18 age group because, in reality, when you look at the homicides, the vast majority of these homicides of children occur between the ages of 14 and 18 years old. I discussed the age group that I chose with Dr. Gray, who is the vice president for Pediatric Services at the Detroit Medical Center. And what he said to me was - as a pediatrician he treats children between the ages of 0 and 18 - developmentally, you are not an adult when you are 16, 17 or 18 years old. And these are children that are living in a very violent community, often have extreme poverty at home, are dealing with a tremendous amount of stress, and it comes out in violence on the street.
MARTIN: Paris, could you talk a little bit more, though, about some of the efforts that you and others are making to try to intervene in this cycle? I mean, you were telling us earlier, you know, that people say - well, in terms of getting access to prenatal care and things like - that a lot of people say, well, why don't they go to the doctor when they know that they're pregnant? And you're saying, well, it's hard to concentrate on that when you don't, you know, have any - you know, your utilities are shut off or you're kind of otherwise living a precarious existence. But despite that, you are making efforts. I mean, with things like - what are some of the interventions - are there interventions that you're finding that are helpful or that you'd just like to talk a little bit more about?
RUTLEDGE: Well, first I'd like to just piggyback on Karen in saying that, you know, you have a 16-year-old that is not developmentally an adult, but they become pregnant and suddenly - sometimes professionals expect them to be suddenly adults because they're pregnant. And, you know, it just doesn't work that way. But we work with the moms one-on-one in their home. We have a nurse and social worker that go out and, you know, we educate them on the importance of going to all of their prenatal appointments because a lot of times, you know, you go and you wait and they'll say, well, I waited all this time and all they do is measure my stomach. You know, so we try to educate them that if something is going on with your pregnancy and you miss a prenatal appointment, than that's a month before you see the doctor again - whereas if you had a major appointment, they could've potentially caught or found out what it is that's going on. You know, we try to teach them to eat properly and eat healthy. You know, I had a mom, years ago, that didn't realize whatever went in her mouth affected the baby. So we try to educate them prenatally and postnatally for the baby because, you know, a lot of people a long time ago, you know, they'd give the baby smashed up food and all of that and we know that their systems aren't developed to digest that.
And it was totally a different time, way back when our grandparents grew their own vegetables and their meats and everything. So all of the chemicals and things that are in them, in food now, wasn't there. You know, we help assist them with negotiating with utility companies to make arrangements. We teach them how to be more responsible in their business dealings, you know. Something as simple as getting a rent receipt when they pay their rent so they have proof that they've paid their rent, if it comes down to that. So there are a lot of just basic living things that we assist them with, as well as the resources and items that they will need for their baby once the baby is born.
MARTIN: Well, it's a very complicated issue, as you said. And we've just only scratched the surface here, but I want to thank you both for talking with us about this. Paris Rutledge works with the Infant Mortality Program for St. John Providence Health System. Karen Bouffard is a health care writer for The Detroit News. Karen, I hope you'll keep us up-to-date on your reporting on this.
BOUFFARD: I will, thank you very much.
MARTIN: And they both joined us from their offices - their respective offices in Detroit. Thank you both so much for speaking with us.
RUTLEDGE: Thank you so much and have a blessed day. Transcript provided by NPR, Copyright NPR.