Forsyth County health staff report modest declines in preterm births but persistent racial gap in infant deaths

Forsyth County Department of Public Health staff reported to the Forsyth County Board of Commissioners that preterm births and low-birth-weight births have trended downward from 2019 to 2023, but the county—s infant mortality rate and large racial disparities persist.

The presentation, given by Joshua Swift of the health department, said Forsyth—s infant mortality rate for 2023 was 6.8 deaths per 1,000 live births compared with a 6.9 statewide rate, and that non-Hispanic Black infants in the county experienced 14.1 deaths per 1,000 live births versus 4.8 per 1,000 for White infants, a disparity ratio of 2.94.

Swift told commissioners the department reviewed multiple measures that influence infant mortality, including preterm birth (delivery before 37 weeks) and low birth weight (under 5.5 pounds). Forsyth—s preterm birth share was 10.9 percent in the period shown, about even with the state rate of 10.8 percent; low-birth-weight births were 9.9 percent in Forsyth versus a 9.4 percent state average.

Swift outlined local programs intended to reduce infant deaths and improve maternal-child health, including care-management services for high-risk pregnancies, a Nurse-Family Partnership program, WIC nutrition services, a two-year Healthy Beginnings initiative focused on breastfeeding and postpartum depression, and an Improving Community Outcomes for Maternal and Child Health (ICO for MCH) grant that coordinates work with Guilford County. He said the department also convenes the Infant Mortality Reduction Coalition and has recently supported a grassroots group called Forsyth Mamas that centers mothers with lived experience.

Swift said the department received $6,000 from the state for a five-week safe-sleep media campaign targeting women aged 18–45 in Forsyth County. The communications campaign, which ran on platforms including Facebook, TikTok, YouTube and Snapchat with particular focus on ZIP codes 27101, 27105 and 27107, generated about 800,000 impressions and approximately 65,000 full 15-second video views.

The presentation moved into the county—s statutorily required Child Fatality Prevention Team review process. Swift said the county—s subcommittee reviews all child deaths and refers selected cases to a full team that includes medical examiners, a district court judge, representatives from the district attorney—s office, law enforcement, Insight, Daymark, the school system, Guardian ad Litem and a parent representative. For the 2023 calendar year, the county received 59 child-death cases; 30 were infant deaths and 23 cases (39 percent) met criteria for full-team review.

Swift summarized causes reported in the 2023 reviews: extreme prematurity, congenital conditions, illness, homicide, unsafe sleep/co-sleeping, accidental injury (including one drowning), motor vehicle crashes (four), other transportation accidents, fire, ingestion of a foreign substance, and two suicides. He said unsafe-sleep deaths have trended down from earlier peaks but still appear in recent years and were a focus of the media campaign.

Commissioners and staff discussed the disparity in infant mortality. Commissioner McDaniel (referred to in the transcript as Miss McDaniel) asked about community groups and funding opportunities; Swift and others named Forsyth Mamas, a local group organized through the health department, and Boston Thurman (a community organization represented in the coalition). Commissioner Wilson and others praised prenatal care and community programs; one commissioner emphasized the potential benefit of maternity housing and prenatal supports.

Swift described the child-fatality review team—s goals as identifying systems issues (for example, communication breakdowns between agencies or rules that may inadequately protect children), recommending system-level changes, and developing action plans. He said the county is one of about 30 counties with a subcommittee structure owing to the number of child deaths reviewed.

No formal votes or motions were recorded in the transcript. Swift said corrected presentation materials would be provided to the commissioners.

The presentation concluded with a request for questions and commissioners recessed afterward.

Sources: Forsyth County Department of Public Health presentation to the Forsyth County Board of Commissioners; remarks by Joshua Swift and commissioners during the meeting.