EDITOR'S NOTE: Childbirth and breastfeeding can be a challenge for all women. But for women of color, the odds of death and miscarriage are far greater. Black babies are almost two-and-a-half times as likely to die in their first year of life as white babies. Today, Gazette columnist Sara Foss begins a three-day series looking at local infant mortality rates and what's being done to address them.
Kyshawn Tyree Hope's time on earth was short — just 1 hour and 45 minutes.
But that didn't make his life any less precious.
DAY 1: Birth Justice Project hopes to see more Capital Region women use doulas
DAY 2: New Baby Cafe in Schenectady aims to help nursing mothers
DAY 2: Glenville, Albany women form Black Breastfeeding Empowerment Network
DAY 3: Improving birth outcomes should be a priority
His mother, Schenectady native Shekia Hope, says she thinks about Kyshawn every day.
"His brothers and sisters talk about him," Hope told me, when I asked her about the baby boy who died shortly after he was born in 2003. "They know that he was here, and then he wasn't."
Hope left the hospital with the onesie Kyshawn was wearing, his footprints and handprints, and his umbilical cord. She says he was born early, at seven months, and that "he couldn't breathe that good on his own."
"For that 1 hour and 45 minutes, I loved him," Hope told me. "That 1 hour and 45 minutes was everything to me. I wanted him to know, in that 1 hour and 45 minutes, that I loved him."
The pain of losing a baby never goes away, and it's something far too many American women and families are struggling with. Hope's story is a sad one — but it's far from the only story like it.
The U.S. infant mortality rate is higher than the infant mortality rate in other wealthy countries — about 71 percent higher, on average, than in countries such as France, Japan and Canada, according to a recent report from the Paterson-Kaiser Health System Tracker. Each year, more than 23,000 U.S. babies will die before reaching their first birthday.
These findings are troubling, because they suggest that America is failing some of its most vulnerable residents.
But they tell only part of the story.
Dig a little deeper, and you'll see that some U.S. babies are far more likely to die than other babies.
Black babies are almost two-and-a-half times likely to die in their first year of life as white babies. In 2015, the black infant mortality rate was 11.7 deaths per 1,000 live births; for white babies, it was 4.8 deaths per 1,000 live births.
The problem is national in scope, but it exists at the local level, too.
Albany County has the highest African-American infant mortality rate in the state — 23.2 deaths per 1,000 live births, according to the state Department of Health's 2016 health equity report. For white babies, the infant mortality rate is 4.7 deaths per 1,000 live births.
I live in Albany, and these figures astonished me.
I knew about racial health disparities — that African-Americans experience diabetes, heart disease, stroke and other chronic conditions at higher rates than whites.
But until I looked at the data, I didn't realize how much more likely black women are to lose a baby than white women, or the degree to which black children lag behind their peers, in terms of their overall health, from birth.
From before birth, really.
The problem is especially pronounced in neighborhoods with large African-American populations, which tend to have higher rates of infant mortality.
Take Schenectady's 12307 zip code, which encompasses the city's Hamilton Hill neighborhood, where the majority of residents are black and Hispanic.
Between 2012 and 2014 there were 35 infant deaths in Schenectady County, eight of which — 22 percent — occurred in the 12307 zip code, according to New York State Vital Statistics Data.
Countywide, the infant mortality rate for black babies was 12.1 deaths per 1,000 births between 2011 and 2013. For black babies, it was 5.4 deaths per 1,000 births. Schenectady County is unusual in that its infant mortality rate for Hispanic babies is much higher than the Hispanic infant mortality rate statewide: 13.6 deaths per 1,000 live births vs. 4.2 deaths per 1,000 live births.
The good news — yes, there is some — is that Schenectady County's African-American infant mortality rate is on the decline.
Since 2006-2008, it has dropped 33 percent, and while the exact reason is difficult to pinpoint, I suspect that local efforts to reach at-risk mothers and give them extra support and education are making an impact. I'll talk about some of these efforts in columns in The Daily Gazette on Monday and Tuesday — and offer some thoughts on what else might be needed.
In places where the infant mortality rate is high, we can assume that the health of the overall community lags behind in other ways — that other health problems, such as obesity and asthma, are also more prevalent.
"You don't create healthy babies in nine months," Kathryn Mitchell, the Albany-based maternal and child health director for the March of Dimes, told me. "You have to look at the bigger picture. ... Women and children are like a canary in a coal mine. They're one of the indicators that tell us whether we have a healthy community."
You might expect racial disparities in infant mortality to diminish, or perhaps even disappear entirely, as you climb the income/education ladder.
But that's not the case.
Black women of all education and income levels are much more likely to lose a baby than white women — as a 2016 report from the Washington, D.C., — based think tank The Brookings Institution noted, "Babies born to well educated, middle-class black mothers are more likely to die before their first birthday than babies born to poor white mothers with less than a high school education."
This is a troubling finding, because it suggests that the gap in infant mortality cannot be explained by pointing to higher rates of poverty in the African-American community. In fact, health experts aren't really sure why black babies die at much higher rates than whites, Hispanics and other ethnic groups.
We do know that a leading killer of babies is premature birth, and that black women are much more likely to experience a premature birth. According to the March of Dimes, in New York the preterm birth rate among black women is 48 percent higher than the preterm birth rate among all other women. Alarmingly, new data suggests these disparities might be worsening.
"We're very poor as a nation for overall maternal outcomes and infant mortality," Mitchell said.
For the many women who have lost a baby, it's a devastating development.
Rensselaer resident Shannon Bensalah coordinates a support group, called EASE, for women who have lost a baby. She joined the support group about five years ago, after her son, Cameron, died in the hospital after being born early, at 27 weeks. Cameron lived 98 days, surviving a week past his due date.
"His lungs never developed to the point where he could breathe," Bensalah, now 32, recalled. "I felt really alone."
But she wasn't alone.
"Pregnancy loss is 1 in 4," Bensalah said, noting that her support group includes people who have lost babies due to to miscarriage, ectopic pregnancy and other causes. "It happens a lot. I don't think people realize how much it happens."
People might not always realize how emotionally shattering losing a baby is, Bensalah said.
"People think if you have another child, you're replacing the child you lost, but that's not the case," she said. "My son passing away was a horrible thing. I think about it all the time."
Hope, who is African-American, told me she felt God's presence in the hospital room when her son died.
"It got so warm and bright, and I knew it was time for him to go, that the angels had come for him," she said.
I wrote about Hope, who recently moved from Schenectady to Pittsfield, Mass., last winter.
A recovering heroin addict, she took the bus from Schenectady to Albany every morning for methadone treatment, and I joined her on one of her trips to the clinic. When I asked her whether she knew any African-American women whose babies died before their first birthday, her answer was brief: "Me." She said that when Kyshawn died, she was drug-free, but under a lot of stress.
Hope has five other children, but that doesn't lessen the impact of Kyshawn's death.
"Any death hurts," she said.
Reach Gazette columnist Sara Foss at firstname.lastname@example.org. Opinions expressed here are her own and not necessarily the newspaper's. Her blog is at https://dailygazette.com/blogs/thinking-it-through.
Infant mortality rates per 1,000 live births 2011-2013
Source: New York State Department of Health