Black infant mortality rate more than double the rate among white infants: CDC
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(NEW YORK) — Infant mortality rates remained relatively unchanged from 2022 to 2023, but racial and ethnic disparities still persist, new provisional federal data released early Thursday finds.
The U.S. provisional infant mortality rate in 2023 was 5.61 infant deaths per 1,000 live births, unchanged from the 2022 rate, according to a report from the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS).
The report also found that infants born to Black mothers still died at much higher rates than those born to white and Asian mothers — more than double the rate of white infant mortality, according to the CDC.
Additionally, changes in the neonatal mortality rate from 3.59 deaths per 1,000 live births in 2022 to 3.65 deaths per 1,000 live births in 2023, and the postneonatal mortality rate from 2.02 deaths per 1,000 live births to 1.96 deaths per 1,000 live births from 2022 to 2023 were not seen as statistically significant, the report’s authors said.
Neonatal refers to the first four weeks of an infant’s life and postneonatal refers to the period between 28 days and 364 days after birth.
Dr. Danielle Ely, co-author of the report and a health statistician at the NCHS, said 2022 was the first year there was a significant increase in the infant mortality rate in about 20 years. That the rate did not increase in 2023 shows the rise in 2022 was likely not a fluke, she said.
“So what we’re seeing is that what we were hoping would be just a one-year blip is now a two-year higher rate,” she told ABC News. “It is unfortunate that it did not go down again to where it was in 2021 at least or at least down from 2022. It just quite literally stayed the same, the infant mortality did.”
Black infants died at a rate of 10.9 infant deaths per 1,000 live births, more than double the rate of 4.5 deaths per 1,000 live births for white women and 3.4 deaths per 1,000 live births for Asian women, per the CDC data.
Infants born to American Indian and Alaska Native women also had higher rates than white and Asian women at 9.2 deaths per 1,000 live births, according to the report.
Data also showed infants born to Hawaiian or Pacific Islander women died at a rate of 8.2 deaths per 1,000 live births, and those born to Hispanic women died at a rate of 5.0 deaths per 1,000 live births.
Why racial disparities continue to persist is “the $100 million question,” Dr. Kirsten Bechtel, a pediatric emergency medicine physician at Yale New Haven Children’s Hospital and an expert in infant mortality, told ABC News.
“One of things that’s great about this data is that it helps us work backward. It’s like the canary in the gold mine,” Bechtel, who was not involved in the report, said. “Death is an outcome that everyone agrees on is a problem, but why that problem happens is oftentimes subject to vigorous discussion.”
She said one reason behind the disparities could be that Black mothers have a higher rate of pre-term birth, and pre-term birth is associated with higher infant mortality.
“That has a lot to do with access to timely prenatal care,” Bechtel said. “Trying to get folks access to timely care during pregnancy and timely care that is evidence-based. We also know there is some elements of structural racism that is built into some of the care these women receive.”
Bechtel said the findings show that pregnant people need to be supported financially with access to medical care and by the community helping take care of a child.
“Raising a child can be very daunting, especially if you have socioeconomic challenges or you have to go to work and you can’t take time off after your baby’s birth,” she said. “So we really need to look at policies that support pregnant people.”
Harika Rayala, M.D., MSJ, is a neurology resident physician at the University of Virginia and a member of the ABC News Medical Unit.
(VANCOUVER ISLAND, CANADA) — Police in Canada said they have arrested six people and taken down an organized crime group believed to have produced tens of thousands of counterfeit cannabis-laced candy bars and edibles resembling popular name-brand products.
The takedown began early this month when the Pacific Region Royal Canadian Mounted Police federal policing investigators executed search warrants at two dispensaries and five separate residences on Vancouver Island in British Columbia, Canada, on Oct. 3, according to a statement from the Royal Canadian Mounted Police on Tuesday.
“These warrants were associated to an organized crime group allegedly involved in the production and distribution of illicit drugs, and contraband tobacco in Port Alberni and Nanaimo,” authorities said. “The dispensaries in question were Green Coast Dispensary in Port Alberni and Coastal Storm Dispensary located in Lantzville.”
Search warrants were also executed at a suspected stash site in Port Alberni, as well as a storage and production facility adjacent to Coastal Storm Dispensary, including two modular trailers where cannabis edibles were being produced, stored, and distributed, authorities said.
The list of items seized includes over 120,000 cannabis edibles with packaging resembling popular name-brand chocolate bars, potato chips, nacho chips, honey and other candies, including over 3 kilograms (6.6 pounds) of psilocybin mushrooms, 1,740 psilocybin capsules, over 400 psilocybin chocolate, candies and a multitude of other psilocybin products, 2.2 pounds of pressed cannabis resin, over 500 pounds of cannabis bud, more than 19 pounds of shatter, over 5000 cannabis vape cartridges, counterfeit cannabis-laced honey, five vehicles, two ATM machines containing cash, an estimated 164 master cases of contraband tobacco equating to 82,000 packs of cigarettes, over $400,000 in cash and a shotgun, police said.
“Although the contraband cannabis-laced candy bars and chips resembled professionally manufactured, packaged, and quality-controlled products, they were discovered to have been produced in the highly unsanitary, and heavily contaminated modular trailers,” authorities from RCMP said. “A preliminary assessment of the edibles also indicates that they had been treated with unknown amounts of THC, and likely cross-contaminated with other drugs and substances present in the trailers where they were being produced and packaged.”
Of equal concern, according to police, was the fact that the counterfeit snacks had packaging claims of possessing medicinal properties and dangerously high drug potency values, with many of the candy wrap labels claiming to be “100 times more potent than regulated cannabis products.”
“Given the highly contaminated and unsanitary conditions of the illicit drug production facility where these cannabis edibles were being produced, it is possible that the consumption of these products can lead to serious health risks,” RCMP said. “We urge members of the public to practice extreme caution if they already possess, or come across such products in the future, especially with Halloween being just around the corner.”
This investigation is ongoing and numerous drug-offence-related charges are being pursued.
(WASHINGTON) — The U.S. Food and Drug Administration authorized the first over-the-counter combination COVID-19 and flu test outside of emergency use on Monday evening.
This means the Healgen Rapid Check COVID-19/Flu A&B Antigen Test is available without a prescription. The FDA said the test is for those who are experiencing respiratory symptoms.
While there are other over-the-counter combination tests currently available, this is the first to be marketed to consumers using the traditional approval pathway outside of a public health emergency.
The new combination test uses a nasal swab sample to deliver at-home results for COVID-19 and influenza in approximately 15 minutes.
Healgen’s test detects proteins from both SARS-CoV-2, which is the virus that causes COVID-19, and influenza A and B, which are the viruses that cause flu.
“As we enter this year’s annual flu season with respiratory illnesses such as COVID-19 on many of our minds, our ability to detect these pathogens effectively and efficiently can be impactful on our daily lives,” said Dr. Michelle Tarver, acting director of the FDA’s Center for Devices and Radiological Health, in a statement. “Today’s authorization expands the options for individuals with respiratory symptoms to receive information about their health from the comfort of their home.”
“The FDA continues to take actions that support the development and availability of at-home tests for a variety of medical conditions,” the statement continued.
The test is for use by people 14 and older who can take their own sample, or those 2 and older, who have a sample taken by an adult, according to the federal health agency.
Data reviewed by the FDA found the test correctly identified 99% of negative and 92% of positive COVID samples. Additionally, the test correctly identified 99.9% of negative flu samples, and 92.5% and 90.5% of positive flu samples, respectively.
Like other over-the-counter COVID-19 antigen tests, the FDA says a positive test result likely means a patient is positive while a negative rest result may require a confirmation test.
However, people who test negative and continue to experience symptoms including cough, fever and shortness of breath should follow up with their health care provider, the FDA says. Similarity, the FDA says those who test positive should take appropriate precautions to avoid spreading either virus and should also follow up with their health care provider.
While the United States has made considerable progress fighting the HIV/AIDS crisis since its peak in the 1980s, headway has not been equal among racial/ethnic groups.
Overall, HIV rates have declined in the U.S. and the number of new infections over the last five years has dropped among Black Americans and white Americans. However, Hispanic and Latino Americans have not seen the same gains.
Between 2018 and 2022, estimated HIV infections among gay and bisexual men fell 16% for Black Americans and 20% for white Americans, according to data from the Centers for Disease Control and Prevention. Meanwhile, Hispanic Americans saw rates held steady, the CDC said.
There may be several reasons for the lack of decline, including Hispanic Americans facing health care discrimination, experts told ABC News. Some may also face the stigma that prevents patients from accessing services or makes them feel ashamed to do so. There is also a lack of material that is available in their native language or is culturally congruent, experts said.
“Where we are in the HIV epidemic is that we have better tools than ever for both treatment and for prevention, and we have seen a modest slowing in the rate of new infections, but we have seen a relative increase in the rate of new infections among Latino individuals, particularly Latino men who have sex with men,” Dr. Kenneth Mayer, a professor of medicine at Harvard Medical School and medical research director at Fenway Health in Boston, told ABC News.
“So, the trends are subtle, but they’re concerning because it does speak to increased health disparities in that population,” he continued.
Hispanic Americans make up more cases and more deaths
Although Hispanic and Latino Americans make up 18% of the U.S. population, they accounted for 33% of estimated new HIV infections in 2022, according to HIV.gov, a website run by the U.S. Department of Health and Human Services. This is in comparison with white Americans, who make up 61% of the U.S. population but just 23% of HIV infections.
Hispanic and Latino gay men currently represent the highest number of new HIV cases in the U.S.
What’s more, Hispanic males were four times likely to have HIV or AIDS compared to white males in 2022 and Hispanic females were about three times more likely than white females to have HIV over the same period, according to the federal Office of Minority Health (OMH).
Additionally, Hispanics males were nearly twice as likely to die of HIV Infection as white males and Hispanic females to die of HIV Infection in 2022, the OMH said.
Erick Suarez, a nurse practitioner and chief medical officer of Pineapple Healthcare, a primary care and HIV/AIDS specialist located in Orlando, Florida, told ABC News that watching the lack of progress made in the HIV/AIDS crisis for the Hispanic and Latino population is like “traveling back in time.”
“When I say traveling back in time for the Hispanic/Latino population with HIV, I mean [it’s like] they are living before 2000,” he said, “Their understanding of treatment and how to access it is in that pre-2000 world. … The state of HIV and AIDS in the Hispanic/Latino population in the United States right now is a few steps back from the general American population.”
He said many Hispanic/Latino HIV patients come to the United States unaware of their HIV status. If they are aware of their status, they come from countries where prevention and pre-exposure prophylaxis (PrEP) is hard to find or doesn’t exist.
When they get to the United States, they be afraid or unsure of where or how to access health care. Even Hispanic/Latino Americans whose families have been here for generations, have trouble accessing health care due to racial and ethnic disparities, Suarez said.
Previous research has shown Hispanic/Latino Americans with HIV reported experiencing health care discrimination, which could be a barrier to accessing care.
Facing discrimination, stigma
Hispanic and Latino patients with HIV report facing discrimination in health care, experts told ABC News. A CDC report published in 2022 found between 2018 and 2020, nearly 1 in 4 Hispanic patients with HIV said they experienced health care discrimination.
Hispanic men were more likely to face discrimination than Hispanic women and Black or African American Hispanic patients were more likely than white Hispanic patients to face discrimination, according to the report.
There may also be stigma — both within the general population and within their own communities — associated with HIV infection that could prevent patients from accessing services, according to the experts.
Suarez said one of his most recent patients, who is Cuban, traveled two hours to a clinic outside of their city to make sure no one in their familial and social circles would know their status.
“The interesting part is that even though I speak with them like, ‘You understand that everything that happens within these walls is federally protected, that it is private information. No one will ever know your information, and our goal is for you to get access healthcare. You can do this in your own city,'” Suarez said.
“Now, because of the stigma, they will travel long distances to avoid contact with anyone and make sure that no one knows their status. So, stigma is a huge factor,” he continued.
Rodriguez said this stigma and mistrust has led to many Hispanic and Latino Americans to not seek medical care unless something is seriously wrong, which may result in missed HIV diagnoses or a missed opportunity to receive post-exposure prophylaxis, which can reduce the risk of HIV when taken within 72 hours after a possible HIV exposure.
Making resources ‘available, attainable and achievable’ Experts said one way to lower rates is to make information on how to reduce risk as well as how to get tested and treated available in other languages, such as Spanish, and making sure it is culturally congruent.
However, Rodriguez says translating documents is not enough. In the early 2010s, when the CDC was disseminating its national strategy to reduce HIV infection, the agency began to circulate materials on how to reduce HIV incidence, reducing stigma and increasing use of condoms for sex, Rodriguez said.
He said that of a compendium of 30 interventions, maybe one was in Spanish. When he took the materials back to his native Puerto Rico, many were having trouble understanding the materials because it has been translated by someone who is of Mexican heritage.
Secondly, rather than the materials being written in Spanish, they had been translated from English to Spanish, which doesn’t always translate well, Rodriguez said.
“When we talk about Hispanics, we have to talk about, first of all, the culture. Our culture is very complex. Not one Spanish language can speak to all of the Hispanic communities,” he said. “And then we also have to look at the generations of Hispanics. Are you first generation, second generation, third generation? “
He added that the key is making resources “available, attainable and achievable.”
This month, the White House convened a summit to discuss raising awareness of HIV among Hispanic and Latino Americans and to discuss strengthening efforts to address HIV in Hispanic and Latino communities.
Mayer said it’s also important to make sure information is disseminated on social media that is culturally tailored for Hispanic and Latino experiences.
“It’s important for social media to seem culturally relevant, to make sure that they understand that HIV is not just a disease of old white guys, and that they may have a substantial risk,” he said. “Make sure that they’re educated by what they can do to protect themselves since we have highly effective pre-exposure prophylaxis, and we have ways to decrease STIs with a doxycycline post-exposure prophylaxis.
The experts added that having more Hispanics and Latinos represented in medicine, research and public health may encourage more Hispanic and Latino Americans with HIV or at risk of HIV to seek care or treatment.
“Seeing and being able to recognize that your healthcare provider looks like you, sounds like you, in some way it represents you, is a key aspect of getting people on treatment and access,’ Suarez said. “And not only that, but keeping them in treatment and having them come back and stay and keep that going, that’s a key issue.”
