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A LIFE-AND-DEATH PUZZLE

The news from Niagara County is disturbing: African-American infants in Niagara Falls are dying at twice the national rate for black infant mortality, and the countywide statistics aren't much better.

Worse, no one knows exactly why.

There are theories, to be sure, but so far there's not enough information to provide definitive answers. Alarmed by the statistics, the Niagara County Legislature has taken the wise step of forming a 42-member community-based Task Force on Infant Mortality to study the issue. Finding reasons for the tragic toll is imperative. So is taking action once those findings are in. Over the past five years, the death rate for black babies in Niagara Falls has averaged 27.5 per 1,000 live births. State Health Department figures show the death rate for white babies in the same city averaging just 6.1 per 1,000.

The national average for all races was 7.1, putting the two major races in the city on opposite sides of an awful divide. The mortality rate for blacks under 1 year old -- excluding miscarriages and stillbirths -- is the same as the infant mortality rate in Bosnia during seven years of warfare.

It seems likely that poor prenatal care -- often tied to poverty, lack of education and lack of insurance -- is a factor. Such care helps prevent low birth weights, the most frequent cause of death for black infants. In Niagara Falls, the percentage of babies weighing less than 5 1/2 pounds at birth has been increasing slightly since 1989; now at 9.5 percent, it, too, exceeds the national average.

But low birth weight can have environmental causes as well, and poverty may not be the only factor. While the ZIP code covering Niagara Falls' inner city has no private physician's offices, Mount St. Mary's Hospital does run a clinic in the heavily African-American North End. That clinic provides prenatal and neonatal care to the uninsured, and no patient there has added to the infant mortality toll in the past two years. According to the state, more than half the Niagara County babies who died before age 1 had received early prenatal care.

Whether the startling death rate can be linked to young women who don't seek care early enough in their pregnancies, to economic disadvantages that condemn them to poor diets in problem-prone neighborhoods, or to some still-undiscovered cause, this investigation must continue. Niagara County's Legislature should give the task force the support it needs, to find answers to this life-and-death puzzle.

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