RALEIGH - A decades-long effort to reduce the number of North Carolina babies who die in infancy took a setback last year as the death rate rose 5 percent, state health officials reported Thursday.

For every 1,000 babies born in North Carolina in 2007, more than eight died before they reached a year old.

Many were born to poor mothers, and a disproportionate number were black, Hispanic or American Indian. The state's infant death rate for minorities was 13.9 deaths per 1,000 births, more than double the rate for whites of about 6.3 deaths per 1,000 births.

"Infant mortality and poor birth outcomes are part of a cycle," said Dr. Leah Devlin, state health director. "They stem from a lack of opportunity and education, and poverty."

Too many young mothers, Devlin said, are overweight, do not exercise, smoke cigarettes and have chronic diseases that put their pregnancies in peril. As a result, she said, public health efforts must encourage women of childbearing age to take better care of themselves so that when they become pregnant their bodies are able to handle the extra stress.

"We have not been able to create a culture in young women of being as healthy as possible going into pregnancy," Devlin said.

That problem is compounded because about half of all pregnancies in North Carolina are unintended, making it hard to target an audience.

Still, health leaders have made some headway when they've focused money and effort on certain pregnancy and child-rearing issues.

Despite the overall increase in death rates last year, the rate of sudden infant death syndrome dropped to 8.9 percent of infant deaths from 9.1 percent, in part because of programs that teach parents to put babies to sleep on their backs. Research has shown that SIDS, a mysterious occurrence in which babies inexplicably stop breathing, can often be prevented with this simple measure.

Additionally, efforts to improve pregnant women's access to prenatal care have resulted in fewer premature and low-birthweight babies -- the leading reasons infants die.

But additional progress remains difficult, health leaders said. North Carolina has hovered at the bottom nationally in infant mortality rates and now ranks 44th, despite 30 years of improvement. The reasons for that are complicated, said Selena Childs, executive director of the N.C. Child Fatality Task Force, a legislative study commission that works to lower the state's childhood death rate.

"When you look at rates for African-Americans, it's much higher," Childs said. "There are connections to disparity and discrimination for generations. There are health patterns that get passed down through generations. We are, for the most part, a rural state. The challenges of getting quality health care and having access to quality health care in rural, low income areas are great."

Get $150+ in coupons in every Sunday N&O. Click here for convenient home delivery.