Preventable deaths.

Byline: The Register-Guard

Of all the statistics associated with Lane County's unacceptably high fetal-infant mortality rate, perhaps the most alarming is where the "excess" deaths are occurring. We're losing the most babies in the period between 29 days after birth to 1 year old.

These are full-term babies who weigh at least 3.3 pounds at birth. They've survived the critical first 28 days of life, but for a number of baffling reasons won't reach their first birthday.

If there is a shred of good news in these grim statistics, it's that an analysis of the causes of death within this group of babies suggests that more than 60 percent of the deaths could be prevented. But more detailed information is needed before public health agencies know which strategies might help the most.

The concept of an "excess" death rate for Lane County babies can be tough to grasp. It's derived by comparing the Lane County death rate for infants in the 29 days to 1 year old group with a national reference group that statistically demonstrates the best potential to have healthy babies.

The national reference group, defined by maternal characteristics, is comprised of non-Hispanic white women 20 years of age or older with 13 or more years of education. Among this reference group, the fetal-infant mortality rate is 5.8 per 1,000 live births. While this is the best rate in the United States, it's no better than mediocre in comparison with European and other industrialized nations.

Nonetheless, public health officials everywhere strive to create conditions that allow all U.S. pregnancies to get as close as possible to the national reference group. With that as a benchmark, Lane County's fetal-infant mortality rate of 9.5 per 1,000 live births reveals a serious problem.

Subtracting the national reference rate from Lane County's fetal-infant death rate (9.5 minus 5.8) produces an "excess death rate" of 3.7 per 1,000 in Lane County. Between 1999 and 2003, there were 26 "excess" infant deaths in the 29 days to 1 year old group when compared with the national reference group - just over five a year.

Thirty-six percent of those deaths resulted from Sudden Infant Death Syndrome or other "ill-defined mortality," and 24.5 percent were caused by accidents. Another 24.5 percent include "all other causes of death," and 15 percent died as a result of congenital abnormalities.

With more data, it may be possible to discover additional preventable causes of death within the "all other causes" category, offering hope that well over 60 percent of Lane County's infant deaths in the 29 days to 1 year old group can be prevented.

Unfortunately, gathering more data will cost more money - about $150,000 - that Lane County flat doesn't have and isn't going to get, unless it can obtain grants or other contributions.

To date, the county's efforts to locate funding for a Fetal-Infant Mortality Review haven't been successful.

At some point, Lane County residents are going to have to ask themselves this question:

Is it acceptable to have more babies die here - from preventable causes - than elsewhere in Oregon for want of a measly $150,000?

That's chump change compared with what this community is capable of contributing to, say, a cherished university athletic program.