Infant Mortality is a Civil Rights Issue

The below story is re-printed from WKNO-FM: NPR for the Mid-South.  Theresa Chapple is one of our MCH program graduates.  Theresa works for the Memphis, TN, Shelby County’s Fetal & Infant Mortality Review.

A link to the audio interview can be found here:


MEMPHIS, TN (WKNO) – Here in Shelby County babies die at a rate almost twice that national average. Figuring out why is Theresa Chapple’s job. Chapple heads up Shelby County’s new Fetal & Infant Mortality Review.

Despite the enormity and gravity of her work, Chapple is spunky. She’s short and well dressed. She often smiles displaying a gap between her front teeth.

Chapple is the first to say infant mortality doesn’t effect everyone equally. Nationwide a black woman is more than twice as likely as a white woman to lose her baby.

“We don’t know who we’re losing when we lose these babies before they turn one,” Chapple said. “We could be losing the next leader in the African-American community.”

A black woman with a Master’s degree is still more likely to lose her child than a white woman who hasn’t graduated from high school.

“So we know it’s more than education, it’s more than class,” Chapple says. “It’s something else; and it is something that has to do with race in this country.

Chapple wasn’t born caring about infant mortality. She was a senior in college in Chicago preparing to apply to law school when she attended a lecture about racial disparity in birth outcomes.

“That’s when I found out that it was a major problem in our communities. I am shocked that I made it that long in my life without realizing,” Chapple said.

The lecture was called Infant Mortality from 1900 to 2000.’ In those 100 years infant mortality has decreased for whites and blacks. But the gap between races hasn’t. And in 2000 it started getting wider.

“I remember leaving that day trying to figure out what epidemiology’ meant,” Chapple laughs. “What was this word that he kept using? And how could I do that in order to make a difference?”

Instead of a law degree, Chapple has a master’s in maternal and child health and a doctorate in child reproductive and perinatal epidemiology.

Chapple works with hospitals, funeral home directors, and the county cemetery to identify every fetal and infant death in the county. After each death she sends a nurse to grab the medical records, and a social worker to talk to the family.

That information is then passed to a Case Review Team. The team determines the circumstances that led to that baby’s death, and comes up with recommendations for what the community, as a whole, can do to make sure those circumstances are less likely to be repeated. The team doesn’t assign blame, and it never determines a death unavoidable.

“My view is that there are no accidents. We may have to look hard for it, but there it going to be someplace that we can intervene,” Chapple said.

Finally the recommendations of the Case Review Team are passed to a Community Action Team. It’s the job of the community team to make the recommendations a reality.

In Memphis the racial disparity in infant mortality is even larger than it is nationwide. Here a black woman is about three times more likely to lose her child than a white woman.

“I would like to really understand why,” Chapple said. “Why would race have that much of an impact on rather your baby lives or dies?”

One of the leading causes of infant death is premature birth and the complications that come with it. In Shelby County infants are indeed being born too small and too early more often than other places across the country. Doctors know what contributes to prematurity it’s things like stress, the age and health of the mom, and not getting any prenatal care. Smoking, drinking, or using drugs during pregnancy also plays a part. But none of that solves Chapple’s mystery.

“That doesn’t help explain what’s going on here in Shelby County that’s making us higher than the national average,” Chapple explained.

And finally there’s being black. As well as being more likely to lose a baby, a black woman is also more likely than a white woman to have a baby preterm.

Chapple says she doesn’t yet know why Memphis has one of the highest rates of infant mortality in the nation, but this, she senses, is at the heart of it.

“It definitely is a justice issue, and it definitely is more than a health issue. It’s not just a medical approach that is going to fix this it’s a societal approach. I see this as our new civil rights issue.”

Find Shelby County’s Fetal & Infant Mortality Review on Facebook under ‘ShelbyCo Fimr’ and on Twitter at

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