Where's the urgency?

Our view: Despite efforts, Baltimore made little progress in reducing infant mortality last year and nothing suggests that this grim statistic will change this year

January 26, 2009

Rickeya Robinson left home one day last April to pick up her older kids and bring them back to the house. But when they returned, an ambulance was sitting out front: Ms. Robinson's 2-month-old infant son Zy'key, whom she had left in the house with her brother, had suddenly stopped breathing. Paramedics were unable to revive the child.

Sudden infant death syndrome is the second-biggest killer of children under 1 year old in Baltimore. Only disorders related to short gestation and low birth weight take a greater toll. In 2007, the last year for which statistics are available, 19 of the 112 infant deaths in Baltimore were attributed to SIDS, whose only symptom is the sudden and unexplained death of an apparently healthy infant.

Ms. Robinson, her children and brother and the child's father were devastated by the loss, as were members of both their extended families. Nearly a year later, they are still grieving.

Yet the tragedy that shattered their lives will likely touch just as many Baltimore families this year as it did last. Despite the efforts health officials are making to reduce infant deaths in the city, little progress has been made. The state health department expects no significant change in Baltimore's infant mortality rate this year. Maryland's infant mortality rate of eight deaths per 1,000 births exceeds that of Singapore and Cuba. Baltimore's rate is even higher -11.3 deaths per 1,000 births. It's an appalling loss of life in a state that boasts some of the best medical care in the country.

Baltimore's health commissioner, Dr. Joshua M. Sharfstein, is drafting a comprehensive plan to improve birth outcomes in the city. It focuses on services before, during and after pregnancy that have been shown to have a positive impact, including better primary health care for young women, substance abuse and smoking cessation programs for both men and women and support for victims of domestic violence. Health officials also want to mobilize community support groups in high-risk neighborhoods.

But the plan is still on paper. Meanwhile, current programs remain scattered and underfunded, and officials realize they may not have the resources to cover the whole city. Dr. Sharfstein estimates his agency would need several million dollars in additional funding to fully implement the plan.

Every infant death is a terrible tragedy for families. And the enormous costs of caring for low-birthweight babies ultimately are shared by everyone. Reducing infant mortality and low-birthweight deliveries is a question of humanity, but it's also common sense. All babies born in Maryland, one of the wealthiest states in the nation, deserve the same chance at a healthy life.

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