Good health at the very outset of life provides a foundation for lifelong well-being. A healthy start allows young children to explore their environment and develop strength and flexibility. Michigan is making little progress in this area.

ONE IN FIVE MICHIGAN BABIES IS BORN TO A MOTHER WHO HAD LESS THAN ADEQUATE PRENATAL CARE.

Prenatal care is particularly important for women who have not had access to regular primary care and may be suffering from conditions that jeopardize their own health and thus that of their infant. Babies born to these mothers who often also do not receive adequate prenatal care face an even higher risk of having an unhealthy start. Adequate prenatal care is defined as having begun in the first two trimesters and having provided regular contact throughout the balance of the pregnancy.1 While most Michigan babies born in 2006 were to mothers who had received adequate prenatal care, roughly one in five were born to mothers who had not (22%).  Over the trend period the number of babies affecteddropped from 33,000 in 2000 to 28,000 in 2006.

Despite some improvement over the past decade African American mothers and infants continue to suffer from the highest rates of less than adequate prenatal care—38 percent compared with 31 percent for Hispanics and 19 percent for whites in 2006. Between 2000 and 2006 Hispanics experienced the greatest improvement; their rate dropped from 40 percent to 31 percent.

EVERY DAY IN MICHIGAN THREE INFANTS DIE.

In 2006 roughly 980 Michigan infants did not survive their first year of life. The leading causes of infant death include congenital abnormalities (birth defects), pre-term birth/low-birthweight, Sudden Infant Death Syndrome (SIDS), problems related to complications of pregnancy, and respiratory distress syndrome.

The Michigan infant mortality rate declined slightly between 2000 and 2006—from 8.1 to 7.6 deaths per 1,000 infants. On this indicator the state compares poorly with other states in the nation. Michigan’s 2005 infant mortality rate gave the state its worst ranking—37th of the 50 states—among the 10 key nationalKids Count indicators.

Rates and trends in infant mortality in the state differed dramatically by racial/ethnic group. African American infants suffered the highest mortality rate—14.5 deaths per 1,000 live births compared with 5.7 for whites and 11.3 for Hispanics. Between 1997 and 2006, however, infant mortality rates for whites and African Americans reflected some decline while the Hispanic rate rose sharply—from 8.3 deaths per 1,000 to 11.3.

ROUGHLY 1,000 MICHIGAN TODDLERS TESTED AS LEAD POISONED IN 2007.

Despite the removal of lead from gasoline and paint in the 1970s, environmental lead in older homes in Michigan remains a significant threat to the healthy development of young children. When lead enters the human body, usually through the mouth or the nose, it eventually circulates in the blood stream and collects in soft tissues of the body, such as the liver, kidneys and the brain. It also settles in the bones and teeth, where it is stored for many years. Young children are especially vulnerable to the far-reaching impact of lead poisoning because their rapidly developing nervous systems are particularly sensitive to the poison’s negative effects. Studies have shown that children with elevated lead levels are at greater risk for learning problems, behavior problems and reduced intelligence. The longer a child is exposed to lead, the more likely it is he or she will suffer from these effects.

Annual data between 2002 and 2007 show that the number and percentage of Medicaid-enrolled children under age 3 tested for lead during the year doubled—from 25 percent to 50 percent of enrolled children. Over that same time period the numbers of non-Medicaid-eligible children tested for lead remained at roughly 20,000 each year.

Of the 84,400 Michigan toddlers tested in 2007, nearly 1,000 were lead poisoned by the current standard of 10 or more micrograms of lead for every deciliter of blood, the standard set by the Centers for Disease Control and Prevention.  Several recent studies suggest that lead burdens much below the current standard can affect children. The defining threshold for lead poisoning has been lowered several times before reaching the current value. Before 1970, a child was not considered lead poisoned until the blood lead concentration reached 60 micrograms per deciliter.

MORE CHILDREN IN THE STATE DEPEND ON MEDICAID FOR ACCESS TO HEALTH CARE.

Children without health insurance are far less likely to get the care they need to assure healthy growth and development. Most Medicaid-enrolled children qualify due to living in families with incomes below 150 percent of the poverty level ($31,540 for a two-parent family of four in 2007). In 2007 roughly two of five children in the state were covered by Medicaid—a total of 874,000 children.

In Michigan, child participation in Medicaid rose sharply between 2000 and 2007—from 21 percent to 33 percent of all children ages 0-18—representing an increase of 55 percent. Every county in the state experienced increased child enrollment in Medicaid over this period with the most dramatic upsurges in the most affluent counties in the state—Livingston and Ottawa—where the rates more than doubled. These trends may have resulted from job loss and decreased family income, as well as changes in employer-sponsored health care benefits.