Saving young lives

Our view: A city plan to reduce infant mortality could be a model for the state

April 09, 2009

Baltimore's aggressive plan to reduce an infant mortality rate exceeding that of many developing countries is a long-overdue response to a health crisis the city has struggled with for years. At 11.3 deaths per 1,000 births, the city's rate is nearly 1 1/2 times that of the state; among African-Americans, the rate is twice as high in some neighborhoods. And despite previous efforts to attack the problem on multiple fronts, Baltimore's high death rates have remained depressingly constant over the years.

The new strategy, announced by health officials Tuesday, targets infant deaths in the 12 city neighborhoods where rates are highest, on the theory that if infant mortality in just a dozen high-risk communities can be reduced to the statewide rate of eight per thousand births, the city's overall rate will drop significantly.

In broad outline, the plan calls for mobilizing each of the targeted neighborhoods around 11 essential services, which range from primary health care, obstetrics, home visits and mental health care to domestic violence intervention, substance abuse treatment, nutrition support and safe-sleep education. All have been proved effective in reducing infant deaths, but until now, efforts in the city have been scattered and underfunded. The new plan standardizes the type and quality of all 11 services in each of the targeted communities and coordinates them so that every resident can be covered.

A key element of the plan is to connect pregnant women and new mothers with the services. To that end, a citywide media campaign will encourage them to participate. Health officials talk about neighborhoods taking ownership of the problem by working together to solve it. And communities are getting help: Half the three-year program's initial $6 million cost is being underwritten by CareFirst BlueCross BlueShield, with the city and state chipping in the rest. Officials estimate that when the plan is up and running in all 12 neighborhoods at highest risk, the cost could rise to $20 million, and they are already trying to identify alternative funding sources.

Meanwhile, the state Department of Human Resources has expressed interest in expanding the Baltimore model to other jurisdictions. What's certain is that everyone has a stake in the success of the city's initiative, because the payoff could be hundreds of young lives saved across the state. That's should be something all Marylanders can support.

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