To Alma Roberts, Maryland's grim statistics on infant mortality affect more than babies. They serve as an indicator of the state's overall health. And she's alarmed.
Maryland has struggled for a decade with infant death rates above the national average - it ranked 31st in 2005 statistics - and figures released last month showed the problem getting worse. In 2007, the infant mortality rate increased, and the racial disparity in infant deaths widened. Last year, 14 newborns died per 1,000 live births, and black infants were three times as likely as white infants to die within their first year.
"This is huge," said Roberts, president and CEO of Baltimore Healthy Start, a nonprofit that seeks to combat racial disparities in infant deaths. "Infant mortality is one of the most sensitive indicators of the health of a community, and here is Maryland totally out of line with the nation."
In response to the latest data, state and local medical officials, community advocates and health care providers are planning an assault on the complex problems concerning infant health.
Years ago, the medical community combated infant mortality by simply pushing for more access to prenatal care, which is considered vital for healthy birth outcomes.
Now, officials are calling for that and then some, including emphasizing the importance of women's health before conception, examining patient safety in hospitals statewide and investigating whether facilities are equipped to handle high-risk pregnancies. Health experts are also pushing for the expansion of community-based efforts such as Healthy Start, which recently launched an awareness campaign called Cradle of Hope during a rally in Baltimore.
"We are looking at rethinking the whole approach," said Dr. Joshua M. Sharfstein, the city health commissioner. "There are limits to what prenatal care can accomplish, and for many it's coming so late. The health of the mother before she becomes pregnant is so critical to a successful pregnancy."
Leigh Cobb, health policy director for Advocates for Children and Youth, called the racial disparities "appalling" and the overall mortality figures, "shameful." While health experts are vexed by the factors that contribute to poor birth outcomes and racial disparities, they must confront them in new ways, she said.
