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A life and death matter

Our view: Infant mortality is a symptom of a larger public health crisis, and solving it requires more than a network of at-home health advocates for pregnant women and young mothers

December 01, 2008

Young women like Taneya should be at the center of a wider campaign because Baltimore's fight to reduce the number of infant deaths remains an uphill struggle. City Health Commissioner Joshua Sharfstein acknowledges that focusing on pregnant women and new mothers alone won't solve the problem. Infant mortality is a complex pathology with multiple causes: lack of access to health care, chronic illnesses such as diabetes, hypertension and obesity, and substance abuse. It reflects a larger health crisis among women in disadvantaged communities that calls for intervention throughout a woman's life cycle, from childhood and adolescence through adulthood. It won't be solved overnight.

Workers like Ms. White can still make a difference in families like Reya Johnson's. But if state and city health officials want to drive Baltimore's infant mortality rate below the national average of 6.7 per thousand births, they are going to have to strengthen home-visiting initiatives like Healthy Start across the city. And, more critical, they will have to expand the capacity and quality of health care services in poor neighborhoods and launch a dedicated outreach effort to ensure that more of the city's residents are receiving them. Until that happens, far too many Baltimore infants will continue to die.

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