RALEIGH — North Carolina's infant mortality rate took its sharpest drop in two decades in 2010, dipping from nearly eight deaths per 1,000 live births to seven, state officials announced Tuesday.
It's the lowest rate ever recorded in the state, down from 12.6 per 1,000 in 1988, when North Carolina's rate was the worst in the nation, and down from about 100 deaths per 1,000 live births in the early part of the 20th century.
The biggest gains were among African-American families, long a focus of public health initiatives in the state because of infant mortality rates that are more than double those for white babies.
The rate for African-American infants improved by nearly 20 percent, falling from 15.8 deaths per 1,000 births in 2009 to 12.7. The rate for white infant deaths fell from 5.5 deaths per 1,000 births to 5.3.
State Health Director Jeff Engel cautiously embraced the improvements.
"Obviously this is good news, but of course we'd like to see that gap (between white and African-American rates) shrink," he said. "I'd also like to see this continue for two or three years so that it's clear that it is a trend."
Infant mortality is considered a key measure of the overall health of a population. It reflects not only the health of mothers and children but also underlying disparities among socioeconomic and racial groups.
Engel and other state officials credited the improvements to a patchwork of several state- and federally funded programs implemented at the county level and aimed at maternal and child health.
One of the most expensive, and most successful, targets high-risk mothers, he said. The Nurse-Family Partnership, which gets some of its funding from private sources, pays for a registered nurse for every 25 families, targeting high-risk moms who are young, poor and having their first child. Nurses work with the mothers for two years, beginning before a baby is born, coaching and lending them support.
Because of the cost, it can be funded only in a few counties, Engel said.
Similar initiatives in other states have been under way for years and have proved effective not only in improving infant mortality but also by other measures of success among children as they grow, including reduced rates of teen pregnancy among girls and of crime among boys, he said.
Another program, called Healthy Beginnings, worked with 900 pregnant minority women in 2010 without losing a single infant. It emphasized the importance of breast-feeding, taking vitamins and maintaining healthy weight as well as infant sleep safety techniques.
In a news release, Gov. Bev Perdue said the improved mortality rates showed the validity of such programs.
"These encouraging numbers underscore the results when we invest in education, including public health education," Perdue said. "The statistics also show the foresight of our steps to protect the most vulnerable in our society."
The programs are part of an effort stretching back more than 20 years, when North Carolina had one of the highest infant death rates in the country. The Associated Press reported Tuesday that some child advocates warned that the progress made since then could be lost because of budget changes state lawmakers made this year, including the elimination of the Health and Wellness Trust Fund and the ending of a state grant to a clinic at East Carolina University specializing in high-risk pregnancies.
"Unfortunately, decisions by our state legislators in 2011 could put North Carolina back into the dark ages when it comes to infant mortality," said Rob Thompson, executive director of The Covenant With North Carolina's Children, a coalition of child advocacy groups.
Nationally, the overall rate for infant mortality fell slightly, from 6.8 per 1,000 births in 2009, to 6.7. North Carolina was tied with Oklahoma for 44th among the states - the same rank it held for 2009. Mississippi had the worst rate, 10.3, and Massachusetts the best at 4.8.