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Infant Mortality Rates: Failure to Close the Black-White Gap

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Infant Mortality Rates: Failure to Close the Black-White Gap DOCUMENT RESUME ED 255 286 PS 014 706 TITLE Infant Mortality Rates: Failure to Close the Black-White Gap. Hearing before the Subcommittee on Oversight and Investigations and the Subcommittee on Health and the Environment of the Committee on Energy and Commerce. House of Representatives, Ninety-Eighth Congress, Second Session (March 16, 1984). INSTITUTION Congress of the U.S., Washin-ton, D. House Committee on Energy and Commerce. PUB DATE 84 NOTE 367p.; Document contains small print. PUB TYPE Legal/Legislative/Regulatory Materials (090) -- Viewpoints (120) EDRS PRICE MF01/PC15 Plus Postage. DESCRIPTORS *Blacks; Federal Government; Federal Legislation; *Federal Programs; Health Needs; *Health Services; Hearings; Immunization Programs; Incidence; *Infant Mortality; Medical Services; Nutrition; Pregnancy; Prenatal Influences; *Preventive Medicine IDENTIFIERS *Congress 98th; *Department of Health and Human Services; Michigan ABSTRACT This hearing was held in response to a request from the Congressional Black Caucus, which asked the subcommittees to find out if the Department of Health and Human Services (HHS) was doing everything possible to reduce infant mortality, especially the high death rate experienced by Blacks. The hearing opened with statements by both subcommittee chairmen, after which congressional Representatives and the chief of Maternal and Child Health, Michigan Department of Public Health testified to the benefits of various maternal and child programs and the effects of federal and state tunding cuts on these programs. The assistant secretary for HHS discussed current programs and stated that more research was necessary to find out the causes of the discrepancy between Black and White mortality rates. Questions to him focused on planned merging of existing programs into block grants and subsequent loss of funds, the possibilities for increasing the accessibility of health services and nutrition programs, coordinating research efforts with the Public Health Service, and problems in receiving information from his agency. Representatives from the Children's Defense Fund, the Food Research and Action Center, Public Advocates, Inc., and Satellite Clinic, Harlem Hospital also testified. Material submitted for the record was from organizations which gave oral testimony and from the American College of Nurse-Midwives, the Harvard School of Public Health, and the Mexican American Legal Defence and Educational Fund. (CB) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********,f************************************************************* INFANT MORTALITY RATES: FAILURE TO CLOSE THE BLACK- WHITE GAP U.S. DEPARTMENT OF EDUCATION NATIONAL INSTITUTE OF EDUCATION EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) This document has been reproduced as 'Toughie(' from the person or organization originating it Minor changes have been made to improve reproduction quality HEARING Points of view or opinions stated in this docu ment do not necessarily represent official NIE BEFORE THE Position or policy SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS AND THE SUBCOMMITTEE ON HEALTH AND TIIE ENVIRONMENT OF THE COMMITTEE ON ENERGY AND COMMERCE HOUSE OF REPRESENTATIVES NINETY-EIGHTH CONGRESS SECOND SESSION MARCH 16, 1984 Serial No. 98-131 Printed for the use of the Committee on Energy and Commerce U.S. GOVERNMENT PRINTING OFFIbE 31 -265 () WASHINGTON : 1984 COMMIT! EE ON ENERGY AND COMMERCE JOHN D. DINGELL, Michigan, Chairman JAMES H. SCHEUER, New York JAMES T. BROYHILL, North Carolina RICHARD L. =INGER. New York NORMAN F. LENT, New York HENRY A. WAX N, California EDWARD R MADIGAN, Illinois TIMOTHY E. WIRTH, Colorado CARLOS J. MOORHEAD, California PHILIP R. SHARP, Indiana MATTHEW J. RINALDO, New Jersey JAMES J. FLORIO, New Jersey TOM CORCORAN, Illinois EDWARD J MARKEY, Massachusetts WILLIAM E. nANNENIE'YER, California THOMAS A. LUKEN, Ohio BOB WHITTAKER, Kansas DOUG WALGREN, Pennsylvania THOMAS J. TAUKE, Iowa ALBERT GORE, JR., Tennessee DON RITTER, Pennsylvania BARBARA A. MIKULSKI, Maryland DAN COATS, Indiana AL SWIFT, Washington THOMAS J. BLILEY, JR., Virginia MICKEY LELAND, Texas JACK FIELDS, Texas RICHARD C. SHELLY, Alabama MICHAEL G. OXLEY, Ohio CARDISS COLLINS, Illinois HOWARD C. NIELSON, Utah MIKE SYNAR, Oklahoma W. J. "BILLY" TAUZIN, Louisiana RON WYDEN, 0,egon RALPH M. HALL, Texas DENNIS E. ECKART, Ohio WAYNE DOWDY, Mississippi BILL RICHARDSON, New Mexico JIM SLATTERY, Kansas GERRY SIKORSKI, Minnesota JOHN BRYANT, Texas JIM BATES, California FRANK M. ParrEE, Jr., Chief Counsel and Staff Director SHARON E. DAVIS, Chief Clerk/Administrative Assistant DONALD A. WATT, Printing Editor ARNOLD I. HAVENS. Minority Counsel SUBCOMMITTEE ON OVERSIGHT ' INVESTIGATIONS JOHN D. DINGELL,Michigan, Chairman ALBERT GORE, JR., Tennessee JAMES T. BROYHILL, North Carolina JIM SI.ATTERY, Kansas BOB WHITTAKER, Kansas GERRY SIKORSKI. Minnesota THOMAS J. BLILEY, JR., Virginia JIM BATES. California MICHAEL G. OXLEY, Ohio JAMES H. SCHEUER, New York JAMES J. FLORIO, New Jersey EDWARD J. MARKEY, Massachusetts DOUG WALGREN, Pennsylvania MICHAEL. F. BARRETT, Jr., Chief Counsel/Staff Director PHYLLIS FREEMAN, Counsel ANTHONY ROBRINF', M.D. RICHARD LEVINSON, SreCiGt Assistant JAMES T. CHasirrY, Associate Minority Counsel 3 SUBCOMMITTEE ON HEALTH AND THE ENVIRONMENT HENRY A. WA AMAN, California, Chairman JAMES H. SCHEUER, New York EDWARD R. MADIGAN, Illinois THOMAS A. LUYEN, Ohio WILLIAM F. DANNEMEYER, California DOUG WALGP.EN, Pennsylvania BOB WHITTAKER, Kansas BARBARA A. MIKUISKI, Maryland THOMAS J. BLILEY, JR., Virginia RICHARD C. SHELBY, Alabama HOWARD C. NIELSON, Utah RON WYDEN, Oregon JAMES T. BROYHILL, North Carolina DENNIS E. ECKART, Ohio (Ex Officio) GERRY SIKORSKI, Minnesota RICHARD L. OTIINGER, New York TIMOTHY E. WIRTH, Colorado MICKEY LELAND, Texas JOHN D. T)INGELL, Michigan (Ex Officio) KAREN NELSON, Staff Director ANDREAS SCHNEIDER, Assistant Coimsel Rum KATZ, Assistant Counsel ELLEN RIKER, Minority Staff Associate . 'Iv'iv CONTENTS Testimony of: Page Alexander,Vicki,chief,obstetrics and gynecology,SatelliteClinic, Harlem Hospital 262 Blackwell, Angela Glover, counsel, Public Advocates, Inc 221 Boggs, Hon. Lindy, a Representative in Congress from the State of Louisi- ana, and secretary, Congressional Caucus for Women's Issues 24 Brandt, Edward N., Jr., Assistant Secretary for Health, Department of Health and Human Services 94 Davis, Csrolyne K., Administrator, Health Care Financing Administra- tion, Department t? Health and Human Services 117 Dixon, Hon. Julian C., a Representative in Congress from the *State of California, and chairman, Congressional Black Caucus 15 Rosenbaum, Sara, director, Child Health, Children's Defense Fund 223 Sanders, Alas, nutritionist, I, owl Research and Action Center 252 friylor, Jeffrey R., chief, Division of Maternal and Child Health, Michi- gan Department of Public Health 28, 265 Material submitted for the record by: American College of Nurse-Midwives, ataternent 346 Dellums, Hon. Ronald V., a Representative in Congress from the State of California, statement 19 Harvard School of Public Health: Summary entitled "Preserving Essen- tial Services: Effects of the MCH Block Grant On Five Inner-City Boston Neighborhood Health Centers" ,, 349 Health and Human Services ')epartment: Articles from Department publications entitled "Pregnancy and Infant Health" and "Healthy Infante" 129 Memorandum, January 16, 1984, re comments on infant mortality trends 196 Memorandum, March 21, 1984, re NCHS initiatives related to infant mortality data 219 Response to subcommittee questions 184 Mexican American Legal Defense and Educational Fund, statement 356 Michigan Department of Public Health: Letter from Jeffrey R. Taylor to subcommittee staff submitting additional information 267 Oversight and Investigations/Health and the Environment Subcommit- tees: Correspondence with the Department of Health and Human Services re subcommittee requests for information on infant mortality 275 HHS memorandum, July 1, 19132, re congressional hearings on pre- vention strategies for healthy babies and children 194 Excerpt from "The Role of Medicaid in Delivering Prenatal Care to Low-Income Women" 174 Excerpts from Standards for Obstef .e-Gynecologic Services entitled "Obstetrics: Ambulatory Care" and "Maternal Health Poll(" 151 Infant mortality rates, tables and charts 3 rv) 5 INFANT MORTALITY RATES: FAILURE TO CLOSE THE BLACK-WHITE GAP FRIDAY, MARCH 16, 1984 HOUSE OF REPRESENTATIVES, COMMITTEE ON ENERGY AND COMMERCE, SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS, AND SUBCOMMITTEE ON HEALTH AND THE ENVIRONMENT, Washington, DC The subcommittees met, pursuant to notice, at 9:50 a.m., in room 2l23, Rayburn House Office Building, Hon. John D. Dingell (chair- man, Subcommittee on Oversight andInvestigations) and Hon. Henry A. Waxman (chairman, Subcommittee on Health and the Environment) presiding. Mr. DINGELL. The two subcommittees will come to order. This morning the Subcommittees on Oversight and Investiga- tions and Health and the Environment are holding a joint hearing on infant mortality and the persistentdiscrepancy between blacks and whites in regard to infant mortality. Today's hearing comes in response to a request from Congress- man Julian Dixon of the Congressional BlackCaucus. The Caucus has asked us to find out if the Department of Health andHuman Services is doing all that can be done to reduce infant mortality and bring down the particularly
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