ANNAPOLIS - The percentage of Maryland infants who are dying in their first year of life declined sharply last year, reaching the lowest level since record-keeping began more than a century ago.
Lt. Gov. Kathleen Kennedy Townsend and state health officials said yesterday that Maryland's infant mortality rate fell nearly 11 percent, to 7.4 deaths for every 1,000 live births. That's down from 8.3 in 1999 and 9.7 in 1990.
Strong gains were recorded for both whites and blacks.
Officials credited a variety of programs that improve access to health insurance, prenatal care and health information, and they praised the cooperative efforts of state and local health departments and private care-givers.
"We must continue to ensure that families are aware of the importance of perinatal care and that they have access to that care," Townsend said in prepared remarks. Perinatal care includes care before (prenatal) and soon after birth.
But officials noted that the mortality rate for black infants in Maryland in 2000 was 2.8 times that for whites. The rates were 13.1 deaths per 1,000 live births among blacks and 4.7 for whites.
"That's unacceptable," said Dr. Claudia Baquet, chairman of the Governor's Commission for the Prevention of Infant Mortality. "We've got to take steps to close that gap."
Factors contributing to higher mortality among black infants include higher rates of poverty and inadequate access to health insurance, prenatal care and proper nutrition, said Dr. Georges C. Benjamin, Maryland secretary of health and mental hygiene.
There is also a need for more and better health care information. "Sometimes we don't get that message out to the poor community," Benjamin said.
So the state plans to launch a two-year, $800,000 multimedia ad campaign in January to drive home to Marylanders the importance of early prenatal health care.
On hand for yesterday's announcement at the Anne Arundel Medical Center, but fast asleep, was Jack McCarthy, 2 days old, whose parents - Michael and Christi McCarthy of Crofton - participated in the hospital's Special Delivery Program.
The program includes regular prenatal care, health information seminars, lactation consultation and hospital visits. Participants are enrolled as soon as they register, through their physicians, for delivery at the medical center.
Maryland's infant mortality rates have historically been higher than the nation's as a whole. The state's rate of 7.4 deaths per 1,000 live births in 2000 was slightly higher than the most recent national figure of 7.1 deaths per 1,000 live births in 1999.
Yesterday, Benjamin attributed that to Maryland's demographics: "We have a disproportionate number of minorities that drive these numbers higher."
The state has set a goal of lowering overall infant mortality, by the end of the decade, to 4.5 deaths per 1,000 live births.
Infant mortality rates are widely regarded as key indicators of a society's quality of life and quality of health care. The rate is defined as the number of deaths, in the first year of life, for every 1,000 live births.
Advances in medical science and improved access to medical care have been gradually reducing infant mortality in the United States for decades.
In 1940, nearly 1,600 Maryland babies died in their first year of life, yielding a rate of 49.2 per 1,000 live births. That rate had dropped to a fifth by 1990 and has generally continued to decline since then.
In all, 550 babies younger than 1 year died in Maryland last year, down from 596 in 1999, according to the state health department report released yesterday.
The leading causes of infant mortality in Maryland last year were problems linked to low birth weight (less than 5.5 pounds), congenital abnormalities and sudden infant death syndrome.
Deaths from all three factors declined sharply in 2000.
Where specific causes of death were known, however, black infants were 18 times more likely than whites to die from necrotizing enterocolitis - an infection of the intestine in premature newborns.
Black babies were also six times more likely to die as a result of maternal complications of childbirth, five times more likely to die as a result of low birth weight, and three times more likely to die from bacterial infections.
"In a state with the highest median family income, and one of the lowest poverty rates, we've got to do a better job," Baquet said.
Benjamin said the reasons for higher infant mortality among blacks aren't fully understood, but poverty, inadequate health care and poor nutrition are suspects.
He urged news media to "tell the public that if you're pregnant, go right away to your doctor and get early, comprehensive care."
"Our goal," he said, "is an infant mortality rate of zero. Is that possible? I don't know; maybe not. ... But we're going to try for zero."
The state has increased women's access to health care by offering health insurance to uninsured pregnant women through the Maryland Children's Health Program. More than 90,000 women have been signed up. The program also provides coverage for eligible children until age 19.
A variety of other programs - within the medical community and through local health departments - have been created or enlisted to help in reducing infant deaths.
They include medical reviews of infant deaths, supplemental nutrition, home visits and care management of women and high-risk infants, smoking cessation and substance abuse intervention for pregnant women, and the Back to Sleep Campaign to reduce deaths from SIDS.
