South Dakota's high infant mortality rate needs to be addressed, says state health secretary

Aug. 28—FLANDREAU, S.D. — One of the best strategies for raising a healthy baby is making sure her mother is healthy too. And right now, mothers across the state of South Dakota could use some more support.

In Flandreau on July 31, this was South Dakota Secretary of Health Melissa Magstadt's main message as she presented a series of health indicators to the lawmakers in the interim committee on State-Tribal Relations.

South Dakota's infant mortality rate is the highest in the Midwest and Plains states, and the fifth highest in the U.S., with 7 mortalities per 1,000 live births every year. The only other states with this many infant mortalities per year are West Virginia, Arkansas and Louisiana.

Those recommendations and indicators Magstadt highlighted for lawmakers centered on how mothers and local healthcare organizations can make a difference in the lives of infants and children in the state.

"Infant mortality is a thermometer of general population health," Magstadt said. When infant mortality is up, that is an indicator that the rest of a population needs help, Magstadt said.

Eighty percent of the cases of infant mortality in the state were caused by children sleeping in adult beds, unsafe cribs or carseats, Magstadt said.

Another significant cause of infant mortality in the state, Magstadt said, is congenital syphilis. Congenital syphilis occurs when a mother with syphilis passes her infection on to her baby during her pregnancy.

The top method for counteracting infant mortality is through better support for mothers, Magstadt said. Enter South Dakota's Bright Start program, a two-decades old nurse-family partnership health care service that provides income-eligible mothers with free nursing services for the first 24 months of their child's life.

For the first two decades, the services this program provided were only available in Spearfish, Belle Fouche, Rapid City, Pine Ridge, Huron, Aberdeen and Sisseton, but last year, soon after the U.S. Supreme Court overturned Roe v. Wade to restrict abortion rights, Gov. Kristi Noem announced the program would be expanded to encompass the entire state.

The 2022 Legislature granted another $2.5 million to the program to expand its services, and Magstadt said this in line with the Department of Health's goals to get that infant mortality rate down.

"There is a rule in health care that says, 'If you take care of mama, you take care of baby,'" Magstadt said.

Due to the limited service availability of the Bright Start program, Moody County, where the Flandreau Santee Sioux Tribe is located, has not had access to critical family health services since its inception, Magstadt said, and the poor health indicators for children and mothers in that region reflect the need for those services.

Those services include helping new mothers with nutrition, through the WIC program, breastfeeding and childcare tips and tricks, that with the help of the Bright Start program can be disseminated through healthcare organizations even in the most remote health organizations in the state.

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number of other health indicators were also not very optimistic.

The percentage of children vaccinated for measles-mumps-rubella in the state fell from 96.2% in 2018 to 92.7% in 2022. The number of children living in South Dakota during the period was about 217,000, which means at least 5,000 less children were vaccinated for the virus in those four years than in previous years.

In response to that statistic, Magstadt recommended to the committee that regional healthcare organizations, both tribal and state, should focus on engaging with parents to improve vaccination rates in children.

"We need to earn back our trust," Magstadt said. "We need to be palms-up, transparent about this."

Magstadt said the Department of Health will be changing its messaging for childhood vaccinations, especially for those illnesses that are long-term preventable like MMR.