Increasing infant mortality — Trump proposed budget

Published: May 6, 2017
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In 1976, Senator Hubert Humphrey hired me to study what has since become the most important federal programme designed to lower the infant mortality rate. Today, 55 per cent of US babies are participants of the Women, Infants and Children (WIC) programme. If President Trump’s budget cuts are successful, WIC’s $6.4 billion annual funding will be cut by $200 million. Our deplorable infant mortality rate will get worse. Babies who do not need to die will.

That is not to say WIC is as good as it needs to be. WIC is administered by Secretary of Agriculture, Sonny Perdue, a veterinarian who has no expertise in reducing infant mortality. Ideally, the health of pregnant women and their children, in the formative period before their first birthday, would be in the bailiwick of the Department of Health and Human Service’s public health service.

Yes, WIC performs good deeds. It provides nutritious food to low-income pregnant women at nutritional risk. It also provides food to children under age five in recognition of studies demonstrating irreversible brain damage for nutritionally deprived infants and children.

First let’s discuss why the infant mortality rate is so high in the US. The current rate is 6.1. For every 1,000 babies born alive, six die before they reach their first birthday. More babies die in the US than in any developed country. In Spain, the infant mortality rate is 3.1. The primary cause of infant deaths is low birthweight. The primary reason for it is that their mothers are severely anaemic. If the US were serious about reducing the infant mortality rate, all pregnant women would receive prenatal care and anaemia would be treated with appropriate medicine.

Pakistan’s infant mortality rate is 66 deaths for every 1,000 live births. I believe the US has an obligation to help the developing world avert this tragedy. In the process, we must improve at home. Sadly, when tens of millions are dying from famine, most especially in Africa, President Trump’s budget proposal released earlier this year would end all international food relief assistance. Consequently, it is unlikely that in other areas, such as infant mortality, USDA or the US Public Health Service will be of necessary assistance in helping Pakistan or other developing countries.

The WIC programme does not provide prenatal care. For anaemia, funding is not available for iron pills or medication. It is hoped that foods high in iron, including iron-fortified cereal, will serve. Certainly, the $45 a month of nutritious food pregnant women receive helps reduce the rate from being worse. Public policymakers of good will are here faced with a conundrum.

Much of the good WIC does is not related to its target missions which also includes reducing the risk of permanent brain damage in young children. WIC also doubles as an income support programme. The vast majority of children and other family members who benefit from mothers sharing food with their family need it. Yes there are more efficient ways of providing income support. However, programmes that do good are subject to attack when they do not slavishly meet their objectives.

Case in point, following my work for Senator Humphrey, I published an article in The New Republic entitled, “Strictly from Hunger, Teaching Pregnant Women Not to Share Food with their Families.” The year was 1977. WIC had grown from a $20 million programme to $250 million. There was a Democratic President. My critique was influenced by the fact that I lost a sister Nitnah who died shortly after childbirth. My criticism was an attempt to convert personal tragedy into public policy. Barbara Bode, president of the Children’s Foundation and my friend, called saying, “You have sold your soul for 30 pieces of silver.” She never talked to me again. Several texts cite my article as evidence I am a horrible human being. Since then, the programme has grown from $250 million to $6.4 billion.

On Thursday March 23rd, I spoke to Rep Glenn Thompson (R-PA), Chairman of the House Agriculture Supplemental Nutrition Assistance Programme (SNAP) Subcommittee. SNAP’s work is critical to the passage next year of the farm bill because without urban support agricultural legislation will not pass.

Representative Thompson’s first child was born the same year as my first child. Only he was earning $8,000 a year. His wife Penny received WIC vouchers. Thompson said he was embarrassed at presenting the vouchers at grocery stores, but did so realising his future son Parker’s health was at stake.

Keeping WIC at USDA, rather than moving it to HHS, means our country’s infant mortality rate will continue to be an embarrassment. Criticising it runs the risk of allowing the presumably budget conscious to allow more infants to die at birth. Thompson, a Trump supporter, said Trump’s budget proposal should not be regarded seriously. What should be regarded seriously are legislators committed to anti-abortion and right-to-life policies, who will continue to allow infants to die.

Have I found on the Republican right a member of Congress who takes infant mortality seriously and is equipped to do something about it?

Published in The Express Tribune, May 6th, 2017.

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