Byline: DEIRDRE CONNER
Maya Akeelah Alexander was born in the bathroom at Shands Jacksonville.
Inside, in the stall and wracked with spasms of pain and terror, her mother knew delivering at five months was too early.
Outside, in the waiting room of the high-risk pregnancy clinic, they would soon know, too: Maya's heartbeat was strong, but not strong enough.
Two weeks later, she would be one of the staggering statistics that make Jacksonville's infant mortality rate among the worst in the state and the nation.
The losses are equivalent to about seven kindergarten classes every year, according to a new study by the Jacksonville Community Council. As of 2006, black infants died at a rate twice that of white infants.
Deep inequities in the community - in housing, in education, in health care - are at the root of why 130 babies died in Jacksonville that year, said Joy Burgess, a member of the Jacksonville Community Council, Inc. study team and nurse in the University of Florida's pediatrics department.
"The failure of Jacksonville to address the underlying causes ... is killing our babies," she said.
In a way, the problem is less about the babies who died, and more about who's left behind.
These days, the fits of grief that gripped Chiquita Alexander have mostly subsided. What's hardest is watching television or reading about premature babies that survived against all odds.
"Sometimes I cry because I think she should be alive, too," said Alexander, 34.
The odds were never with Maya - or, more accurately, with Chiquita.
It was hard for her to understand, given that she had given birth to five healthy children before that spring day in March 2007. But she is African-American, is at risk for high blood pressure and diabetes and lives in one of the handful of ZIP codes where infant mortality rates are as much as three times higher than other parts of town. The odds eventually won out.
By far, women's general health and prenatal care is the most important factor, accounting for 70 percent of black infant deaths and 58 percent of white infant deaths, according to the study. Black babies were twice as likely as whites to be stillborn or die after being born prematurely and very small.
Low birth weight accounts for about 80 percent of the racial disparity, the study found.
For babies born alive and weighing 3 pounds, 5 ounces or more, the death rates in the first year of life - caused by problems such as newborn care, abuse, neglect or sleep-related deaths - were nearly the same for blacks and whites.
HEALTH CARE AND COSTS
Rates of infant mortality here and statewide declined steadily until the mid-1990s. Since then, the number of infant deaths in Jacksonville has begun to rise again, even as state figures continued to hold steady, according to the state Department of Health.
Health care improved, but access to it has not. A high proportion of Floridians have no health insurance. The state also has low rates of contraceptive use.
"The wonders of medicine can only do so much," said Thomas Chiu, chairman of pediatrics at the University of Florida and head of the Neonatal Intensive Care Unit at Shands Jacksonville.
There, doctors and nurses try to hold off delivery as long as possible, then wrap pre-term infants in a cocoon of tubes and machines in a fight for life.
Chiu, also on the JCCI study team, called infant mortality a indicator for greater problems. Below the tip of the iceberg, he and other experts say, are deep and serious inequities in the health of Jacksonville residents.
Ultimately, Chiu said, everyone pays.
The average cost of care on NICU at Shands is $30,000 per infant, he said.
"We have million-dollar babies in the unit," Chiu said. "That money has to come from somewhere. …