BY PAULY DENETCLAW
NAVAJO TIMES
WINDOW ROCK — The highest child mortality rate in Arizona is among Native American children, says a new report by the Arizona Child Fatality Review Program.
“Our top concerns are the ones that could have been prevented, and that’s over a third,” said Mary Ellen Rimsza, a pediatrician in Phoenix who also chairs the Arizona Child Fatality Review Program.
There are 80 childhood deaths for every 100,000 people every year in Native American communities compared to the state average of 48 deaths for 100,000.
This means the death rate for Native American children is 40 percent higher than the state average.
The study defines a preventable death by determining “if the community or an individual could have done something that would have changed the circumstances leading to the child’s death.”
They also look at “if reasonable medical, educational, social, legal or psychological intervention could have prevented the death from occurring.” This includes looking at the “community, family and individual’s actions or inactions.”
The leading cause of preventable death for children in Coconino, Navajo and Apache counties, which have large Navajo populations, is motor vehicle crashes.
“The preventable factors we find are driver’s who are impaired, failure to use seatbelts, and failure to have infants and young children in car seats,” said Rimsza.
On the Navajo Nation, only 27 to 30 percent of children are put in car seats or booster seats, according to the Navajo Nation Department of Transportation.
This is dangerous for children as vehicles are not made to protect them. For children to be protected during impact they must be in a car seat or booster seat made for their height and weight.
Once children grow out of a car seat, they should still be put in a booster seat until they’re 4 feet, 10 inches, which is usually around 12 years old, according to the American Academy of Pediatrics.
Over the last decade the mortality rate for Native American children has fluctuated from a high of around 115 per 100,000 in 2009 to a low of 53 per 100,000 in 2014.
However, that number is on the rise once again. According to the report, in 2016 Native American children in Arizona were more likely to die from premature birth, unintentional injuries (most from car accidents), Sudden Unexpected Infant Death, maltreatment and suicide. “
Another common cause is suicide, unfortunately,” Rimsza said. “We have a higher mortality rate from suicide among Native American populations than other populations.”
The suicide rate is heavily influenced by access to mental health services, Rimsza said. Adolescent children and young adults need better access to mental health services in order to lower this number.
For newborn children, the concern is unsafe sleep deaths.
In 2016, the state of Arizona saw 78 unsafe sleep deaths. Of those, 10 percent were Native American children.
“There’s been a good job in the Native American community in addressing it but more could be done,” she said. “Fatalities from unsafe sleeping environments unfortunately have been going up and that’s why it’s especially a focus for us.”
Rimsza advises parents to not co-sleep with their newborns as they can’t breath through their mouths yet “and their noses are very soft. And if it gets compressed at all, it only takes a minute or two and they can suffocate.”
She encourages parents to lay newborns on their backs in an empty crib.
“No stuffed animals in the bed,” she said. “No bumpers around the crib. You don’t want anything their face could get compressed with.”
A crib is preferred but a basinet will also work.
This is the 24th annual report from the Arizona Child Fatality Review Program, which was created to review all childhood deaths that occur in the state of Arizona each year, said Rimsza.
The group identifies the deaths that could have been prevented and offers solutions on how to lower those numbers.
Information: www.azdhs. gov/prevention/womens-childrens-health/injury-prevention/