Thirty-three Forsyth babies died before age 1 in 2024. Over the latest five-year period, the Black infant mortality rate was 2.67 times the white rate.
WS Chronicle | Staff Report
Forsyth County will convene health professionals, advocates and families next month to confront a persistent public-health divide: Black babies in the county are dying before their first birthday at more than twice the rate of white babies.
From 2020 through 2024, non-Hispanic Black infants in Forsyth County died at a rate of 12 deaths per 1,000 live births, compared with 4.5 deaths per 1,000 among non-Hispanic white infants.
The N.C. State Center for Health Statistics calculates the Black-white infant mortality disparity ratio in Forsyth at 2.67.
The figures provide a difficult backdrop for the fourth annual Black Maternal and Infant Health Conference, scheduled for Oct. 7 at Winston-Salem State University’s Albert H. Anderson Jr. Conference Center.
Forsyth County Department of Public Health and the Black Pearls Society are organizing the event, whose theme is “Sacred Bodies, Broken Systems: Reimagining Black Maternal and Infant Health.” The county said the conference will bring together health professionals, community leaders, advocates and families and will feature keynote speaker Michelle Browder and a panel of local and regional voices.
But the larger question extends beyond a one-day conference: whether local hospitals, health agencies, medical providers and community organizations can produce measurable changes in the outcomes the gathering is designed to address.
In 2024, 33 Forsyth County infants died before reaching age 1, according to the State Center for Health Statistics. The county’s infant mortality rate was 7.4 deaths for every 1,000 live births.
That was up from 30 deaths and a rate of 6.8 in 2023.
One year’s change, however, should not be treated as a trend.
Because the number of infant deaths in a single county is relatively small, rates can fluctuate noticeably from year to year. The state’s 2024 estimate for Forsyth carries a 95% confidence interval of 4.9 to 9.9 deaths per 1,000 live births — a statistical range reflecting the uncertainty around the annual rate.
The five-year figures provide a more stable view of the racial disparity.
Forsyth recorded 170 infant deaths from 2020 through 2024. Sixty-nine were among non-Hispanic Black infants, resulting in the 12.0 mortality rate. Forty-three were among non-Hispanic white infants, with a rate of 4.5.
The state recorded 45 deaths among Hispanic infants during the same period, a rate of 8.2 per 1,000 live births.
Those figures do not mean race itself explains why an infant survives.
Public-health researchers and providers instead examine conditions surrounding pregnancy, childbirth and infancy, including prenatal and postpartum care, premature birth, chronic health conditions, insurance coverage, transportation, stress and the quality and responsiveness of medical care.
That distinction also matters when discussing the Oct. 7 conference.
Infant mortality and maternal mortality are separate measures. The state statistics cited here measure deaths of babies before age 1; they do not show how many Forsyth County mothers died during pregnancy or following childbirth or how many experienced severe pregnancy-related complications.
Those maternal outcomes require separate data and scrutiny.
Forsyth County already operates programs intended to reach families during pregnancy and after birth.
Its WIC program provides nutrition education, food assistance, breastfeeding support and health care referrals for qualifying pregnant and postpartum women, infants and children through age 5. Applicants must meet residency, income and nutritional-risk requirements, although people receiving Medicaid, Work First or food assistance automatically satisfy the program’s income requirement.
The county also operates Healthy Beginnings, a free case-management program for minority women during pregnancy and up to two years after delivery. Other county services include childbirth and parenting education, transportation assistance for some participants and care management for certain high-risk pregnancies.
The accountability question is how those programs connect with hospitals, obstetric providers, midwives, doulas, pediatricians and neighborhood organizations — and whether residents facing the greatest risks are actually receiving the care and support those systems are intended to provide.
The conference could provide an opportunity for institutions to put measurable commitments behind the discussion.
Among the questions facing local health leaders: How many Black mothers receive prenatal care early in pregnancy? How large are the racial gaps in premature birth and low birth weight? How consistently do patients receive postpartum care? Are doulas, home-visiting programs and community health workers reaching families at highest risk? And what measurable outcomes have changed since Forsyth County began holding the Black Maternal and Infant Health Conference?
Families themselves also have a role in answering those questions.
Black mothers and fathers, grandparents, families who have lost babies, families whose pregnancies ended well and community doulas can describe parts of the health care system that statistical tables cannot — including whether patients felt heard, respected and able to get help when they needed it.
Forsyth County officials say the Oct. 7 gathering is intended to help build more equitable care and healthier communities.
The state’s figures have already established the size of one of the challenges.
What comes next is determining what Winston-Salem and Forsyth County institutions are prepared to change — and how the public will know whether those changes are working.