Rochdale Village Health

(Original Article)

A photo of Ashley McElveen as a baby hangs on the wall to her left as Karen Driggers places a life-sized toy baby in her arms.

On this February day, Ashley is 21, single and 15 weeks pregnant with her first child. She lives with her parents, holds a high school diploma and works as a clothing sales clerk at a nearby shopping mall.

She remains uncertain whether the father of her baby, a boyfriend of six months, has grasped what’s going on or is prepared for the new role in his life.

Registered nurse Karen Driggers visited Ashley McElveen, who is 15 weeks pregnant, in her home in Timmonsville in Florence County. Wade Spees/Staff

She’s typical of far too many young black mothers in a state where the death rate for black newborns runs two or three times that of whites — more in some counties. And that is one of the main reasons Driggers visits her regularly.

Ashley sinks into an overstuffed couch in the den of her parents’ brick ranch home in a neighborhood of tidy, small houses and trailers just off this farm town’s main drag.

The town claims as a favorite son Depression-era FBI agent Melvin Purvis, who famously led the hunt that killed gangster John Dillinger. Nowadays, Timmonsville is best known for the nearby Honda all-terrain vehicle plant.

Three miles from that bustling plant, Ashley cradles the toy baby in the crook of her left arm with the ease of an experienced mother.

The toy baby is a prop Driggers uses to gauge how comfortable first-time mothers-to-be are with what will soon be coming their way.

Driggers is one of dozens of nurses in South Carolina who are part of a national program called Nurse Family Partnership. McLeod Regional Medical Center in Florence, where Driggers works, sponsors the program in four of the 26 mostly rural counties where the program operates.

The four counties — Florence, Darlington, Dillon and Marlboro — are part of McLeod’s service area.

McLeod’s effort also receives money from the Children’s Trust of South Carolina, McLeod Health Foundation, Boeing South Carolina and the Marlboro County General Hospital Trust Foundation.

McLeod sees the initiative as a way to counter the high infant mortality rates and preterm deliveries that plague Florence and the rural Pee Dee counties that surround it. The program got underway in December.

The ‘cradle of death’

Infant mortality is such a crisis in many counties surrounding McLeod that the area is a virtual cradle of death, with some of the state’s highest rates of newborns dying before their first birthdays — nearly double the state average.

For black newborns, the toll is even greater — double or triple that of whites, and more in some cases.

Ashley fits the mold for the type of young mother the program aims to serve. The idea is to pair nurses with low-income, first-time moms to help them build healthy lives for themselves and their babies.

The nurses meet their assigned mothers at home several times every month throughout pregnancy and then after delivery until the babies turn 2 years old.

Ashley was referred to the program by the Florence County Health Department. Her baby is due in August.

Driggers visits nine mothers each week.

The program’s goal is 25 for each of the five nurses currently participating. The program serves 29 mothers, but that number is expected to grow rapidly.

Of the state’s many, but mostly scattered, uncoordinated and underfunded efforts to combat infant mortality, the Nurse Family Partnership offers a proven track record.

It’s a pricey, hands-on program that costs about $4,800 a year per mother. In 2014, the program served 1,286 South Carolina mothers and their babies.

It can cost as much as $6,500 per family, McLeod Nurse Supervisor Kristen Miller said. But she pointed to studies that show it works and that for every dollar spent, it earns a $6.20 return from decreased spending on health care, criminal justice, child protection and other community services.

A report published last year in the medical journal JAMA Pediatrics found significant reductions in infant mortality and other childhood problems as a result of nurses making regular home visits with pregnant women and young mothers. The study in Memphis, Tennessee described such visits with young mothers as “a promising means of reducing … mortality in their first-born children living in highly disadvantaged settings.”

Crucial care

Lack of prenatal care is a key driver of infant mortality in South Carolina.

Recent state data shows that if pregnant women receive little or no prenatal care, their babies face a death risk five times higher than the state average rate.

In 2013, 103 such babies died. These deaths account for 27 percent of the 389 babies who died in South Carolina that year.

Dr. Oscar Lovelace, a family physician in Newberry who has been specially trained to provide obstetrical care to pregnant women, said well-trained family physicians are a crucial building block of an adequate rural medical community.

“The Agency for Health Care Policy and Research has reported that the most cost-effective public health interventions are childhood immunizations and prenatal care for poor women,” Lovelace said.

“South Carolina is falling further behind by not understanding this.”

(Original Article)

Babies in a broad swath of rural South Carolina come into this world with little better chance of survival than a child born in war-torn Syria.

They face a toxic mix of poverty, chronically sick mothers, premature birth and daunting barriers to health care.

The Palmetto State’s infant mortality rate hit an all-time low last year, but that achievement largely bypassed its rural corners, where infants, white and black, still die at third-world rates, a five-month Post and Courier investigation has found.

More than 200 newborns from these rural counties have died on average during each of the last three years, many from preventable problems.

These struggling communities remain largely untouched by a four-year state campaign to stop babies from dying unnecessary deaths.

The state provides relatively little money to support some of the most promising infant death prevention efforts. And the programs aren’t available in some counties that need the most help.

South Carolina has long ranked among the deadliest states for newborns. Since 2000, 6,696 South Carolina babies have died before their first birthday. That’s more than double the number of people killed in the 9/11 terror attacks.

In recent years, noticeable gains have been made in the state’s booming metropolitan areas, where state-of-the-art hospitals and programs exist to help new mothers through the risks of pregnancy and fragile first months after birth. But poor areas of South Carolina have been left behind, with neither the money nor the resources to conquer the problems claiming their young, the newspaper’s investigation found.

Consider the following:

The mothers of more than a quarter of the newborns who died last year received little or no prenatal care. The death rate for those babies is more than five times the statewide rate. For blacks it’s about seven times higher.

The state has seen its infant mortality fall significantly before, only to have it rise again. From 2002 to 2003, the rate dropped more than 10 percent. Then in 2004, it increased by more than 10 percent.

Among blacks in some rural counties, infants die at rates triple that of whites, mirroring infant death rates in such impoverished countries as Vietnam. Worldwide, infant mortality rates are considered a bellwether for a country’s overall health.

Saving money is one of the key motivators behind the state’s desire to improve infant health. That’s because Medicaid in South Carolina pays for more than half of all births every year. The issue is complex. When asked to calculate how much it spends each month on babies in neonatal intensive care, the state declined. Its explanation: the information was not “readily available.”