By Lydia Coutré
Star News Online
SOUTHEASTERN N.C. | Where a baby is born in North Carolina can mean a difference of nearly a decade in how long the person is expected to live.
Facts
By the numbers
New Hanover County
79.6-year life expectancy at birth
1 in 27 births is to a woman who received very late or no prenatal care, which puts both mother and baby at a higher risk for pregnancy complications or poor birth outcomes
1 in 13 babies is born at a low birth weight, which has been found to be the strongest predictor of infant mortality
1 in 16 children is uninsured
23 percent of children live in poverty, which is linked to greater risk for health challenges, such as diabetes, heart disease, obesity and developmental delays
Brunswick County
78.2-year life expectancy at birth
1 in 27 births is to a woman who received very late or no prenatal care
1 in 12 babies is born at a low birth weight
1 in 13 children is uninsured
26.3 percent of children live in poverty
Pender County
78.4-year life expectancy at birth
1 in 19 births is to a woman who received very late or no prenatal care
1 in 9 babies is born at a low birth weight
1 in 11 children is uninsured
27.9 percent of children live in poverty
North Carolina
78.3-year life expectancy at birth
1 in 15 births (6.6 percent) is to a woman who received very late or no prenatal care
1 in 11 babies (8.8 percent) is born at a low birth weight
1 in 4 children (24.9 percent) live in poverty
Source: NC Child
The life expectancies for babies born in New Hanover, Brunswick and Pender counties all fall in the top third of the state, but each have some room for improvement to catch up to Orange County, where babies’ life expectancy is the longest in the state at 81.7 years, according to data from NC Child, an organization dedicated to advancing public policies that improve the lives of children in the state.
Brunswick and Pender counties’ life expectancies, at 78.2 and 78.4 years respectively, are on par with the state’s average of 78.3 years. Babies born in New Hanover are expected to live 79.6 years.
On the other side of the state, babies born in Swain County have a life expectancy of 73.1.
The indicator is for a child born in a particular county, and likely stays there, how long can he or she potentially expect to live based on current mortality patterns, said Laila Bell, director of research and data at NC Child.
How long can a child born in North Carolina expect to live? Explore a map with the details:www.StarNewsOnline.com/lifeexpectancy.
The estimates capture things like income, education, access to quality medical care and food security and access to healthy, nutritious foods.
“That’s why it’s such a compelling measure … because we’re not just talking about what is someone’s genetic inheritance or their genetic predisposition,” Bell said. “We’re talking about what is someone’s access to the supports and resources that really do help them achieve and maintain good health.”
Across the state, the stark differences can point to disparities in all these factors, but the variation doesn’t end there.
“The same kind of wide variation and disparities that we observe between counties, we observe within counties,” Bell said. She’d love to be able to do this analysis on aZIP-code level to offer more information on how outcomes differ within counties.
Area health officials are happy with the current life expectancies for babies born in their counties, but they agree the work is never really done.
More work to be done
“I’m pleased with where we are, but I know that we have a lot of work to do,” Pender County Health and Human Services Director Carolyn Moser said of the county’s life expectancy for babies.
Moser points to prenatal education, outreach to mothers with high-risk pregnancies and the addition of a primary care doctor a couple of years ago as areas that have helped put the county’s indicator on par with state and national numbers (The United State’s average life expectancy is 78.8 years, according to the Centers for Disease Control and Prevention).
But beefing up prenatal education and working to connect more mothers to health care and primary care will help even more.
Moser said she knows the county’s infant death rate has gone up (from 6.8 infant deaths per 1,000 live births in 2009 to 8.7 in 2013), but she attributes that to several high-risk pregnancies in the last couple of years.
“Sometimes you just don’t have any control over that,” Moser said.
Carla Turner, personal health services manager at New Hanover County Health Department, said the life expectancy for babies born in the county is the 14th highest in the state for a number of reasons, including medical and dental outreach and programs for pregnant women, such as childbirth classes and family planning.
As the New Hanover Department of Social Services and the Health Department work to collaborate more, Turner said it should be able to help get people connected to health care more easily, which in turn, will help improve the health of mothers and babies.
“It’s a domino effect,” she said.
Joyce Hatem, care coordination supervisor for New Hanover, said transportation continues to be a challenge in the effort to connect those in need to resources.
“We’ve got a bus system that can get people around, but if you’ve got a mom that has three or four children, it’s difficult to manage getting three or four children on the bus,” Hatem said.
David Stanley, Brunswick County’s Health and Human Services Director, also said transportation is a challenge for the county. He said the department has addressed that over the years by opening clinics across the county, making it a little bit easier for mothers and everyone else, to access those services.
“From a public health standpoint, there’s been a lot of great achievements over the years – especially in the 1900s – that have continuously caused the life expectancy numbers to go up, and I would expect that to continue,” Stanley said, ticking off the past century’s health care achievements from vaccinations to motor vehicle safety to access to safer healthy foods.
And in Brunswick, maternal health clinics, public health social workers at the health department and partnerships with area hospitals, other departments and nonprofit organizations have helped the county push that life expectancy number higher, in addition to many other programs that directly or indirectly reach a mother and baby.
To continue that trend, Stanley said the county needs to look at what it’s already doing and make sure they remain relevant.
“It’s going to be us putting a finer point on programs that we’re operating now and looking for new opportunities based on the science that we see where we can make a difference,” he said.
Statewide solutions
Bell, of NC Child, points to three investments the state can make as a whole to significantly improve children and family health.
The first, is strengthening access to health insurance programs for women of reproductive age by expanding Medicaid to cover adults below 138 percent of the Federal Poverty Line. Right now, there’s a gap of the population that remains uncovered because they make too much to qualify for Medicaid, but not enough to afford purchasing insurance, she said. Such an expansion would help minimize that gap.
Second, Bell recommends the state support infant mortality prevention strategies recommended by the Child Fatality Task Force. Finally, she urges the state to invest in early intervention services to reduce the effects of developmental delays.