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Committee addresses high infant death rate on rez

Jan 8, 2013 - By Alejandra Silva, Staff Writer

Fremont County has the second highest figure in Wyoming, according to reports.

The alarmingly high number of infant deaths on the Wind River Indian Reservation was a topic of discussion at the Wyoming Select Committee on Tribal Relations meeting in early December.

A report that collected data from 2001 to 2011 said an average of seven of 1,000 infants in the state of Wyoming died before their first birthday.

State Sen. Cale Case said the American Indian infant death rate was almost twice as much as the state's average. Roughly 14 of 1,000 infants who died were born to American Indian women while about six of 1,000 infants had been born to Caucasian mothers.

Carbon County reported the highest number of infant deaths before their first birthday, while Fremont County came in second and Sweetwater County came in third.

Ashley Busacker, the senior epidemiology adviser for the Wyoming Department of Health, said these numbers are helpful to public health organizations to show the status of the population.

"It's a reflection of the general health of the community," Busacker said.

She said infant mortality in Wyoming is the highest among the states in Region 8, which consists of Montana, Wyoming, Colorado, Utah, North Dakota and South Dakota.

The Wyoming Pregnancy Risk Assessment Monitoring System is a program that surveyed and monitored pregnancies, children's health and the changes that occurred in both the mother in child.

The survey was conducted by the Department of Health and the Centers for Disease Control and Prevention with the help of both the Northern Arapaho and the Eastern Shoshone tribal health departments.

Wyoming is one of 40 states that carried out PRAMS. The program evaluates the progress and birth-related problems that could affect pregnancies or infants. With this information, officials were able to track the state's progress toward national health objectives.

After collecting these results, officials with PRAMS work to take initiatives and promote better health for both the mother and child through programs like the Women, Infants and Children program and Indian Health Services.

Busacker said the results from PRAMS could change if clinics and hospitals also provided information on infant deaths, but because that information is confidential, it can't be disclosed to anyone except patients and health care providers. She said this information was limited to a select few who responded and cooperated, and those women had death certificates confirmed by the county coroner.

"Our vital records need some work," Busacker said.

House District 33 Rep. Patrick Goggles said when a death doesn't occur at a hospital and isn't confirmed by a coroner, it creates inaccurate data.

"The data would not necessarily reflect those deaths that occurred outside the hospital," Goggles said.

Northern Arapaho Tribal Health director Allison Sage said there is certainly a high number of infant deaths that aren't reported. He suggested that the Indian Health Services be provided with a prenatal care program that can better track and monitor pregnant women. He said many women also choose not to receive prenatal care if they have been pregnant in the past.

Glen Revere from the Indian Health Services said his office is in the process of expanding to assist women with prenatal education.

Busacker said the reason for infant deaths ranges from death a few hours after being born, sudden suffocation or being hit by a vehicle before their first birthday.

Additional statistics

Fremont County is the second highest county with babies born before 37 weeks, based on statistics from 2006 to 2011. At 37 weeks, a baby is considered full term, but a baby is expected to be born healthier after 37 weeks. A baby can stay in the womb three weeks after this period. Niobrara County was the only county in Wyoming with more preterm births.

A number of health problems can derive from an early birth date, including irregular breathing, slower heart rate, intestine problems or a weak immune system that is unable to fight off infections.

Busacker said the Department of Health is working with the March of Dimes Foundation toward a preterm initiative.

"(They're) working at really promoting the importance of 39 weeks of gestation," she said.

About 81 per 1,000 pregnant women are American Indian teenagers while about 38 per 1,000 women are Caucasian teenagers.

"Those are like flags waving, screaming, 'Help! Help!'" Sage said, regarding the high teen pregnancy numbers. "We have children having children."

Busacker and Revere said the Nurse Family Partnership program, which provides maternal and early childhood health education, and the public health nursing staff from IHS operate in several Fremont County schools to educate students on teen pregnancy and other health issues.

A high percentage of women also smoke during their pregnancy; almost 27 percent are American Indian and nearly 19 percent are Caucasian.

Busacker said the most up-to-date birth rate is higher for American Indian women on the reservation because the population has increased.

Northern Arapaho tribal liaison Gary Collins said all tribe members need to come together more often to acquire information, see these statistics and make positive changes in their community.

"I think it's really important, particularly with the numbers we're looking at," Collins said. "That community dialogue I think is critically important not so much just from the medical professionals, per say, but community input (as well)."

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