SOUTHERN CALIFORNIA: Infant Mortality Drops In Six Counties
"Infant mortality rates in Los Angeles and five other Southern California counties dipped and birth outcomes mostly improved" in the first half of the 1990s, according to a March of Dimes report released yesterday. The Los Angeles Times reports that officials attribute the drop in large part to the higher numbers of women seeking prenatal care in the first trimester of pregnancy. "In general, the health of babies and mothers has improved during the 1990s," said Dr. J. Robert Bragonier, March of Dimes board member and director of maternal health and family planning programs for Los Angeles County.
Officials attributed the increased prenatal care to "changes in and expansion of the Medi-Cal program." The Times reports that more than half the births in Southern California "are paid for by the state and federal Medi-Cal program." However, officials warned that the "gains are threatened by proposals to cut Medi-Cal eligibility back to pre-1998 levels for many immigrant women." In addition, officials noted that the massive implementation of managed care in the Medi-Cal program could lead to "confusion and reduced access to care for pregnant women."
Prenatal Care Increasing
The March of Dimes study examined trends from 1992 to 1995 in Los Angeles, Ventura, San Luis Obispo, Santa Barbara, Riverside and San Bernardino counties, which combined are home to 14 million people, or 42% of the total California population. All six counties reported that "increasing numbers of women are receiving prenatal care" in the first trimester. According to the Times, "Ventura County led the pack, with 86% seeking such care in 1995, followed by Los Angeles County with 80%." President Clinton has announced that his goal is to have 90% of women receiving first-trimester prenatal care by 2000.
Infant mortality rates also decreased. In Los Angeles County, the "infant death rate fell from 7.7 per 1,000 births in 1992 to 6.7 in 1995, under the federal goal of 7 by the year 2000." However, the infant death rate for African-American infants in Los Angeles County "was more than 14 per 1,000 live births in 1995, far higher than the rate for Latinos, Asians and whites." In addition, death rates for African-American infants were "even higher elsewhere: 15 per 1,000 in Riverside County and more than 20 in San Bernardino County."
March of Dimes officials noted that teenage pregnancy rates remain high in Southern California and statewide, despite being on the decline nationally. According to officials, in 1995, five percent of births in Los Angeles County "were to mothers under 18 -- about average for California -- but San Bernardino, Riverside and Santa Barbara counties exceeded the statewide average." This is of concern because younger mothers are "less likely than older mothers to seek early prenatal care; their children are more likely to be small or to die during their first year of life" (Marquis, 2/5).