January 30, 2014 at 3:54 pm

Surviving through age 18

Detroit is deadliest city for children due to prematurity, violence

Grieving mother speaks on gun violence
Grieving mother speaks on gun violence: Sunsearae Hall talks about the day her son, 12-year-old Kenis Green Jr., was shot and killed at a birthday party in Detroit, and the effect it has had on her family.

Children are dying in Detroit at a greater rate than in any U.S. city its size or larger, a Detroit News study shows.

Mostly, they die of conditions resulting from prematurity — the top killer of Detroit kids — and violence, which ranks second.

“This is a public health emergency in the city of Detroit,” said Dr. Herman Gray, executive vice president of pediatric health services for the Detroit Medical Center and former president of DMC Children’s Hospital of Michigan. “We are losing our future in really socially unacceptable ways.”

All told, Detroit kids through age 18 died at a rate of 120 per 100,000 children in 2010, the most recent year for which complete data is available. Detroit was the only city whose death rate among children topped 100 per 100,000; Philadelphia, at 95.7, was a distant second.

Over six months, The News gathered and analyzed thousands of bits of data from state health departments across the country to rank and compare, for the first time, death rates for children 18 and younger by the major cities in which they live.

Kids in Detroit face greater-than-average health risks from the moment they are conceived, The News found. More die of common childhood illnesses and environmentally linked conditions such as flu and asthma than elsewhere.

In 2010, Detroit (population about 713,000) and Cleveland (population about 390,000) had the highest infant mortality rates of Big City America: 13.5 deaths for every 1,000 live births — higher than in Panama, Romania and Botswana. The measure includes deaths from all causes in a child’s first 12 months, but most are the result of premature birth, which carries with it a host of potentially deadly conditions.

Violence, the second-biggest killer of Detroit kids, claimed 32 young lives in 2010.

“This is not just a police or criminal justice problem,” Gray said. “This is a public health problem (that requires) a coordinated response from the public health agencies, the organized health infrastructure, from the philanthropic community, the educational system.

“Virtually everything that touches our children and youth in some way has to play a role. It really has to be a community effort to address this crisis for our kids.”

Kristen McDonald, vice president of program and policy at The Skillman Foundation, which focuses on improving the futures of Detroit children, said “If kids aren’t safe, nothing else matters.”

“The homicide is horrific, but we actually have to get to this comprehensive place where children are just plain safe, not only safe from homicide but where they’re safe from any sort of attack or any violence when they’re trying to get to school or after-school programs.”

Kenis Green was among last year’s statistics.

Any dreams 12-year-old Kenis may have had of graduation, first dates or senior prom died Aug. 31, when he was gunned down on his front porch as his mother watched helplessly.

Sunsearae “Lo Lo” Hall, her two younger children and an extended family of grandparents, aunts, uncles and cousins are still struggling to cope with the loss. And avoiding becoming direct victims of crime doesn’t mean Detroit kids, such as Kenis’ siblings, will escape its impact: Experts say children who grow up in Detroit face a future of health risks associated with living in an atmosphere of trauma and chronic stress.

“Every time I see a car ride down the street, I still get nervous. I don’t feel safe anywhere,” said Hall, who keeps Kenis’ ashes on the dresser next to her bed.

The deteriorating city impedes its residents’ access to healthy food, medical care, safe housing, police protection and transportation, creating a perfect storm of conditions that threatens its children, according to Columbia University professor Dr. Irwin Redlener, co-founder with singer Paul Simon of New York City-based Children’s Health Fund, which partners with Detroit’s Henry Ford Health System to provide mobile health clinics for Detroit Public schoolchildren.

'Betrayed by leadership'

“You take a bad economy, cutbacks of services, cutbacks in police presence, corruption at the highest levels of government, and you have the impact of all that being an increasing malaise among the population,” Redlener said.

“Communities feel abandoned and betrayed by leadership; you add that to a bad economy and people worrying about how they’re going to pay their rent, and then cutbacks in the social programs create a very demoralizing environment where one is not surprised that there has been increased violence and homicidal fatalities.”

The rates of infant mortality and child homicide worsened in Detroit during the Great Recession, according to state health data.

When the recession hit, Detroit already was wracked by pervasive poverty. Many of its neighborhoods had long been food deserts, where families with spotty access to transportation must travel miles for fresh food.

They also have few primary care physicians, and fewer still who accept government-provided Medicaid insurance. Families lucky enough to find a doctor often postpone visits or delay picking up prescriptions due to a lack of transportation.

“You have large (medical centers) but not as many doctors’ offices as in the past,” said Dr. Elliott Attisha, who runs one of Henry Ford Health System’s mobile health clinics for Detroit students. “Many of the kids we see might have an assigned physician on their insurance card, but don’t have a relationship with that physician.

“Also, a lot of these kids qualify for insurance, but many are not getting their yearly checkups, are behind on immunization; many have asthma and are not getting treatment for their chronic conditions.”

About 20,000 Detroit children have asthma, and most cases are uncontrolled, Attisha said. An average of five children have died each year of asthma over the past decade, state records show, including nine in 2006 and eight in 2007.

Reasons for hope

As grim as the statistics appear, efforts are under way to improve the outlook for Detroit kids. Detroit Police Chief James Craig is targeting crime “hot spots” identified by neighborhood watch groups. Hospitals and private foundations are providing health clinics in Detroit Public Schools.

Gov. Rick Snyder has made infant mortality a priority, and posts updates on the statewide rate on Michigan’s website along with other health and wellness measures. Furthermore, groundbreaking local research is discovering new ways to help reduce infant mortality.

McDonald, of the Skillman Foundation, says focusing on prenatal care and safety can save lives.

“It’s really important to highlight the really significant reasons for hope that have happened,” McDonald said. “I don’t want to miss that, because when we have that kind of momentum it’s really important that we all talk about it. We can make this better.”

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Sunsearae 'Lo Lo' Hall, mother of Kenis Green Jr., holds her son's ashes. Kenis was 12 when he was shot and killed on his front porch. / Max Ortiz / The Detroit News