Indiana ranks eighth in the country for stillbirth and infant mortality numbers, as many counties lack access to obstetric care.

One out of every 165 pregnancies in the state ends in stillbirth, and there are almost seven infant deaths per one thousand live births.

These rates are higher among Black women, so the Indiana Minority Health Coalition is working to reduce them.

The coalition offers the services of doulas - trained professionals who assist before, during and after a pregnancy with physical and emotional support and information.

Coalition Maternal Child Health Manager Lauren Lancaster said doulas are assigned to areas throughout Indiana - and more are needed.

"In our program," said Lancaster, "we have a doula program that covers St. Joseph, Elkhart, Laporte, Howard, Cass, and Miami counties."

According to the March of Dimes, Indiana saw 529 infant deaths in 2019 - the most recent reporting year. The causes include birth defects, preterm birth and low birth weight, maternal complications, and sudden infant death syndrome (SIDS).

The highest number of pregnancy complications are reported in Grant, Madison, Parke, Switzerland and Vanderburgh counties.

In 2020, the leaders of three of Indiana's largest healthcare systems - Community Health Network, Eskenazi Health, and Indiana University Health - acknowledged health care disparities and inequities in the state's minority communities, describing systemic racism a "public health crisis."

Lancaster said Black women should demand equal care for a safe and healthy delivery and baby.

"If you feel that your provider is not acting upon what you believe to be an issue within your pregnancy, go see another provider," said Lancaster. "Or if you have to, go to the emergency room - but make sure that you're being heard and that you're being listened to."

The coalition in partnership with Anthem Health created a multilingual app, "Count the Kicks," to assist those who are pregnant with tracking fetal movement - a key indicator of the baby's health, especially in the third trimester.

Lancaster said in an emergency, the app can verify with a healthcare provider that immediate care is needed.





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This week is Crohn's and Colitis Awareness Week, shedding light on what some call an invisible disease.

Crohn's disease and ulcerative colitis are also known as inflammatory bowel disease, and they affect a person's food choices and many other aspects of life.

Ryan Boyce - executive director of the Northwest chapter of the Crohn's and Colitis Foundation - said symptoms include abdominal pain, rectal bleeding and diarrhea.

But Boyce said many suffer in silence because those symptoms aren't usually visible.

"It's a difficult disease to diagnose and it's very common for folks to really struggle with these symptoms for a while," said Boyce, "before they get properly diagnosed and can begin a treatment path to help improve their health."

A recent study found about one in 100 Americans has been diagnosed with inflammatory bowel disease, or IBD.

Boyce said there's no cure for the disease, although there are a few approaches that can alleviate symptoms, such as medication and changes to a person's diet.

"The unique thing with IBD is that it impacts everyone a little bit differently," said Boyce. "So, there's not one set strategy and plan, or a blueprint if you will, that if everyone follows then it kind of limits symptoms. There's just so much variance with the disease."

Boyce said there have been major strides in the search for solutions for this affliction.

"What we're really trying to do is find cures," said Boyce, "and cures, plural, because it will take more than one cure depending on the disease and the treatment - and pushing toward that."




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November has been Diabetes Awareness Month - but heading into the holidays, people who are diabetic know they can't lose their focus on keeping it in check. And technology is making it easier to monitor the disease from home.

More than 520,000 Washingtonians have been diagnosed with diabetes.

Dr. Mamatha Palanati is the medical diabetes program director for Kaiser Permanente Washington. She said the disease needs to be managed closely, because it can lead to serious health complications.

Palanati noted that fortunately, people don't need to leave their homes to do this in some cases.

"In today's world, there's a much easier way to do it, like telehealth," said Palanati. "Telehealth provides multiple ways for the follow-up and connection to the health care for any individual."

Palanti said people managing diabetes still should plan to see their physician in person at least once a year. Management of other factors, like blood pressure and cholesterol, can also help reduce complications.

Palanati said monitoring technology can also assist people.

"The family members and caregivers, or anyone who can take care of that particular individual," said Palanati, "can do it remotely and manage their diabetes in a much better way."

Palanati stressed that diabetes is a chronic disease.

"Don't look at this as an additional chore or anything," said Palanati. "Make it as a part of your life. So, be active, making sure you adapt to the healthy lifestyles. It may not be perfect, but try your best to get what you can do."




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As World AIDS Day turns 35, the mother of an Indiana teen who became the public face of the disease is a reminder of the importance of never forgetting the hard work of medical researchers and the victims lost in the frenzy to find a cure.

More than 40 million people have died from AIDS, including Ryan White, who grew up in central Indiana at a time when not much was known about it and medicine offered few treatments. Ryan contracted the disease during a blood transfusion at age 13. He became a staunch advocate against discrimination and helped change how Americans view AIDS.

Jeanne White-Ginder, who eventually left Indiana for Florida, said it is imperative to remember all the lost lives.

"That is so important that we remember all the people who got us to where we are today, because they are no longer here," White-Ginder noted. "And I'm not just talking about Ryan, because Ryan was a face, but there are so many people that did all the work."

Just five weeks after Ryan's death in 1990, Congress overwhelmingly passed the Ryan White CARE Act with bipartisan support. The legislation helps more people get tested for HIV and offers assistance to patients in all stages of the disease.

Ryan's mom emphasized AIDS affects people across the spectrum, regardless of labels.

"A gay person has it, a straight person has it, a blood transfusion person has it; it was for everybody," White-Ginder explained. "Once you have AIDS, you're just like everybody else who has AIDS; you're fighting to stay alive. And people fought to stay alive, and people dedicated their lives to get us to where we are today."

She added Ryan would have turned 52 next week.

His mom plans to travel to Indiana University on his birthday, where the Rural Center for AIDS/STD Prevention will present the Ryan White Distinguished Leadership Award to Dr. Joe and Sarah Ellen Mamlin.


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