After years of talking about Guilford County’s stubbornly high infant mortality rate, the Board of Commissioners has decided to stop wringing its hands and start swinging hammers – with a new county task force and a public push that the chairman says won’t let up until the numbers turn around.
The kickoff meeting of the newly established Guilford County Infant Mortality Taskforce is set for Tuesday, Oct. 14, at 4 p.m. in the John H. McAdoo Conference Room on the third floor of the former Truist building at 201 W. Market St. in Greensboro.
The first order of business is to set some goals and figure out why Guilford keeps losing so many children before their first birthday compared to other places.
The board put its intent in writing last month when it adopted a resolution – sponsored by Board of Commissioners Chairman Skip Alston – establishing the task force and declaring the reduction of infant mortality a public health priority and a shared responsibility. The resolution lays out the hard numbers that have frustrated commissioners for years. In 2023, 5,757 babies were born in Guilford County and 53 didn’t reach age one.
The breakdown: 70 percent of those deaths were African American children, 11 percent were Hispanic, 11 percent were reported as Other Race and 4 percent were white.
The county’s infant mortality rate climbed from 7.6 deaths per 1,000 live births in 2021 to 9.2 in 2023 – nearly double the national average of 5.6.
The new county task force is charged with convening hospitals, OB-GYN and pediatric providers, public health, universities, community and faith leaders, social services workers and parents with lived experience meant to identify barriers to care, propose practical solutions and recommend policies and funding priorities. It will report to the Board of Commissioners quarterly and publish an annual update the public can read in a simple and clear fashion.
Alston has been pressing this issue for decades, but two months ago the board’s patience ran thin as members talked openly about how unacceptable the trend has become. In an interview with the Rhino Times, he didn’t bother with euphemisms.
“We had 53 babies die last year in Guilford County,” Alston said. “Thirty-four of those were Black.”
“Tell us what you need,” he said. “I’ll try to fight for you to get it.”
He said the county’s long-time infant-mortality partners shouldn’t be scapegoats when the overall numbers are moving the wrong way.
Alston said he doesn’t blame Every Baby Guilford staff or its director, Jean Workman, who have been on this problem for years through programs like Adopt-A-Mom.
“I’m not the professional,” he said. “I’m just a convener.”
“One child death is too many,” he said. “Black, white, Jew or gentile.”
Alston has already begun lining up a diverse roster for the task force so the meetings don’t become “echo chambers.” He wants an OB-GYN and a midwife in the room, along with pediatric voices, a public health representative, a social services voice, a doula, someone from the faith community, hospital representatives and parents who know the heartbreak first-hand. The idea is simple – get the people who know the terrain to say plainly what’s driving the deaths here and what it would take to bring the rate down.
The list of suspects isn’t short.
Alston said he wants the group to look at access to prenatal care, basic transportation to clinics, nutrition for expectant mothers, housing conditions, mental health and substance-use treatment, and possible environmental contributors.
He also mentioned expanding mobile health clinics so that the county can bring services to neighborhoods where getting to a doctor is a problem.
“We may find that we need more mobile health clinics to go into the neighborhoods where women can’t easily get to a doctor,” the chairman said. “We may find nutrition is the issue. We may find it’s substance abuse.”
The board also continues to back long-running work that’s helping people today. At its most recent meeting, commissioners authorized acceptance of $171,176 from Every Baby Guilford to support Adopt-A-Mom – a 34-year-old program that links uninsured pregnant Guilford residents who don’t qualify for Medicaid to prenatal care and navigation services.
About 260 women a year get connected through Adopt-A-Mom to doctors, interpreters, counseling and referrals that can make the difference between a healthy delivery and a crisis that no family wants to experience.
That said, no one at the dais is pretending the county can grant-fund its way out of this challenge. The resolution’s own numbers make the point: The mortality rate has been drifting the wrong way even with committed nonprofits and a strong provider network. The task force is the county’s way of saying the status quo isn’t cutting it and the work needs to be coordinated, measurable and highly visible to the public.
Alston also made it clear he doesn’t want the new group to become a study hall that files a report and then disappears. A lot of county plans in the past have ended up on the shelf gathering dusts.
He said he has been appointing the members and presenting the roster to the board for transparency and for timely recommendations.
The county’s resolution sets expectations right up front – measurable goals, an eye on disparities and quarterly dashboards that don’t sugarcoat. The board wants root causes named in plain English and wants to see policy changes, budget decisions and partnerships that move those numbers.
If that means more nurse home-visiting where it’s needed, more prenatal clinic slots on evenings and weekends, more translation services, or another mobile unit that shows up where the bus doesn’t, then the board wants that on paper with a price tag attached.
The frustration has never been just about statistics.
Commissioners constantly hear the stories – the mother who couldn’t get off work for an appointment, the family that couldn’t find a ride, the household where healthy food is two bus transfers away, the newborn who should have had a follow-up visit but didn’t. None of those are unsolvable problems in a county with this many hospitals, clinics and smart people.
That’s part of why the board’s tone shifted from concern to urgency.
Alston said he’s heard a lot of talk over the years about what ought to happen, but this iteration, he added, is meant to turn the conversation into checklists and deadlines that the public can follow.
“That’s the question – what is it?” he said of the cause. “That’s why I want to bring these together.”
He said he wants the experts to tell the board exactly which levers to pull, then he wants to pull them – and fund them – without pretending the price is zero.
If the task force says prenatal access is the top driver, the board wants to know which clinics can expand and how quickly, the chairman said. If the data say it’s unsafe sleep, he said, then the county can mobilize the education, cribs and home visits that have cut those deaths elsewhere. If it’s substance use, then prenatal treatment slots need to exist at the hours people can actually show up.
And if the answer is “all of the above,” the chairman said, “then at least the county will be spending money on the right ‘above.’”
Alston said he’ll also keep pushing the agencies already in the fight to be explicit about needs. He said that’s been his message for years and it hasn’t changed.
“Tell us what you need to stop these babies from dying,” he said.
The county’s resolution doesn’t hide from the disparity angle either: With 70 percent of the county’s infant deaths last year among Black children, any serious plan must name that fact and work where the harm is landing.
Alston said the goal isn’t to play politics with the data – it’s to save children and to do it in the neighborhoods where the losses are most acute.
He also said he wants the task force to be as diverse as the county and he wants to keep the conversation practical.
