ENID, Okla. — The effort to build a healthier community begins before birth. That’s the focus of a new initiative at Garfield County Health Department aimed at reducing the county’s disproportionately high rate of infant mortality.

Maggie Jackson, a health educator at Garfield County Health Department, said infant mortality in Garfield County has averaged about 12 deaths for every 1,000 live births over the last five years, significantly higher than Oklahoma’s five-year average of 8 per 1,000, and twice the national infant mortality rate of 6 per 1,000.

According to health department figures, the top five factors contributing to infant death in Oklahoma are:

• congenital malformations, or birth defects.

• disorders related to premature birth or low birth rates.

• Sudden Infant Death Syndrome (SIDS), including sleep-related deaths.

• maternal complications during pregnancy.

• infant injury, including abusive head trauma and shaken baby syndrome.



A sleeper suspect



Jackson said reducing the risk for infant mortality in Garfield County requires education, prevention and changing the overall community environment to make Garfield County healthier for residents of all ages.

One of the simplest changes, Jackson said, is in following safety guidelines when putting babies down to sleep to avoid the risk of SIDS.

“There are avoidable factors contributing to babies dying of SIDS, such as sleep position, being suffocated by sleeping with adults or by having too many blankets or toys in the crib, or by falling off a sleeping surface,” Jackson said.

“Culturally, your mom will pass down to you ‘This is how I put you down to sleep,’” Jackson said. “It seems soothing and nurturing to comfort a baby by having them sleep in your bed, but that can be detrimental.”

She said babies should be placed on their backs in a crib located close to the parents’ sleeping area, without toys or blankets in the crib. Jackson said babies should not be swaddled in blankets to put down to sleep, but should instead wear a sufficiently warm “onesie.”

Jackson said parents should avoid overdressing babies for bed, as overheating increases the risk of SIDS.



Community factors



Aside from preventing SIDS, there are a number of health factors specific to pregnancy that affect the county’s infant mortality rate, including lack of folic acid during pregnancy, gestational diabetes and hypertension.

But, there is a longer list of health factors that affect the community at-large and contribute to infant mortality when women carry their health issues into pregnancy.

Jackson said those include maternal tobacco use and tobacco use in the home after birth; poor maternal diet and nutrition; unhealthy eating habits; and obesity.

Overcoming those environmental risk factors is the long-term solution to lowering infant mortality in Garfield County, Jackson said.



Funding education



Toward that end, the county recently was awarded a $20,000 Preparing for a Lifetime grant from Oklahoma State Department of Health.

The program is a state initiative to provide women and families the education and resources needed to achieve healthier outcomes for their babies.

Jackson said Garfield County Health Department will use the grant to provide educational materials on topics such as prenatal health, breastfeeding, SIDS prevention, tobacco cessation and other topics related to pregnancy and infant health.

She said the grant will enable the county health department to obtain educational materials “culturally appropriate” for the health department’s clients.



MAPPing a plan



The health department also will address infant mortality through its broader initiative to improve health outcomes in the county, Mobilizing for Action through Planning and Partnership (MAPP).

MAPP is a coalition of more than 20 community partner agencies in Garfield County, in the health care, treatment, prevention and social service fields.

MAPP began building a comprehensive plan to improve the county’s health last year. The process began last June with a public listening session, then entered a process of identifying key areas of public health in the county that could be impacted with available resources.

The MAPP coalition recently selected its top six areas of emphasis in the county:

• tobacco cessation

• nutrition and physical activity

• infant and child health

• domestic violence

• chronic disease

• access to health care and mental health services

Jackson said by addressing those areas, the health department and its MAPP partners hope to not only reduce infant mortality in Garfield County but promote lifelong healthier outcomes.



Taking it public



“There are different levels of prevention,” Jackson said, “and the primary prevention is changing the environment in our county. We want to reach all levels of health and change the environment in our county to make it a healthier place to live.”

The next step in the MAPP process will be to conduct a lengthy “Forces of Change Assessment,” an inventory of the county’s strengths and weaknesses related to the six selected areas of emphasis.

During that process the health department and MAPP coalition will continue to host public events aimed at promoting healthier lifestyles.

The next of these events will be the annual “Kick Butts” tobacco cessation and prevention campaign, sponsored by the Garfield County Tobacco Free Coalition.

Kick Butts will begin March 17 with a kickball tournament at Meadowlake Park.

Teams of at least five members will compete for prizes and bragging rights.

Teams and individuals also will compete to see who can pick up the most cigarette butts in the park.

Prizes from the March 17 event will be presented March 20 during an awareness day planned at Oakwood Mall.

The March 20 event also will feature a youth poster contest focused on reducing tobacco use in the community.

The health department also will host the “Walk This Way” competition beginning April 13, with teams competing to see which team can log the most miles walked during a six-week campaign.

Jackson said the goal of the Walk This Way competition is to get each team member to walk at least 30 minutes per day and promote healthy exercise habits that will last long after the competition.

Jackson said more details on the Walk This Way and Kick Butts events will be available soon.