Targeting infant mortality

City partnership is raising awareness of the simple steps that can remedy this scourge

August 02, 2010|By Renee Ellen Fox, Wendy Lane and Bronwyn Mayden

Although the infant mortality rate in Maryland showed a promising decline in 2009, there is little cause for celebration in Baltimore City. In contrast to much of the rest of the state, its infant mortality rate (deaths in children less than 1 year old per 1,000 live births) increased from 12.2 in 2008 to 13.5 in 2009.

While the mortality rate among white infants in Baltimore dropped slightly, the mortality rate in black children rose to a shocking rate of 15.8 per 1,000 live births, a rate higher than that of many third world countries. Last year there were 128 deaths of Baltimore City children under age 1. Of those deaths, 26 were sleep related, and likely preventable.

Baltimore County's rates, while lower, also showed the same alarming trend for African-Americans. This is a devastating loss of human life, a tragedy not only for the families affected but for neighborhoods and for the city as a whole. These children could have been our future teachers, firefighters, doctors, nurses or community leaders. Maryland citizens should be outraged about this preventable loss of life, and about the enormous disparity between black and white children.

Fortunately, the state of Maryland and the city of Baltimore have viewed these deaths as a needless loss of future citizens and have begun efforts to reduce the infant mortality rate. At the state level, Gov. Martin O'Malley has established a strategic goal of reducing infant mortality by 10 percent in the next three years.

The Baltimore City Health Department is addressing this critical issue. In April 2009, the department published "The Strategy to Improve Birth Outcomes in Baltimore City." The executive summary states: "The strategy starts with the understanding that many factors contribute to prematurity, low birthweight, and unsafe sleep — the three leading causes of excess infant death in the city. These factors include the health of the mother and father before conception, medical and social support during pregnancy, and access to critical knowledge and services after birth." The city Health Department's broad, population-based approach will implement programs to address the health of families before, during and between pregnancies.

A partnership among the Family League of Baltimore City Inc., CareFirst BlueCross BlueShield Foundation and the city Health Department was formed recently to fight infant mortality in Baltimore City. The "B'more for Healthy Babies" initiative will address infant mortality throughout the city, and will also offer focused efforts in three communities with "excess infant mortality": Upton/Druid Heights, Patterson Park North and East, and Greenmount East. The three neighborhood programs will improve access to 11 evidence-based, high-impact services that are known to improve birth outcomes. These include primary care in a medical home, obstetric care, home visiting, referrals for drug and alcohol treatment, intervention for domestic violence, referrals for mental health care, smoking cessation, family planning, nutrition support, breastfeeding promotion and safe sleep education.

The B'more for Healthy Babies: Upton/Druid Heights program is a comprehensive, community-based model built on the premise that organizations working within the same community can provide services more effectively and synergistically when they coordinate their efforts. We will promote coordination and collaboration among the citywide B'More for Healthy Babies initiative, health care and social services providers, faith-based organizations, civic and business groups, and residents of the Upton Druid Heights community to foster measurable and sustainable improvement in birth outcomes, and in maternal and child health. The University of Maryland Medical Center and the University of Maryland, Baltimore will provide expertise in program coordination and evaluation. Furman Templeton Elementary School and the Robert Marshall Recreation Center, in the heart of Upton/Druid Heights, will serve as our bases of operations.

Safe Sleep Education is the focus of the first B'More for Healthy Babies citywide campaign. Eliminating sleep-related deaths is a very low-cost intervention, requiring only that caregivers follow a simple recommendation for safe sleep: A-B-C, which stands for Alone, on his/her Back and in a Crib — no exceptions. If all of Baltimore's babies were sleeping alone, on their backs and in a crib, those 26 children who died in unsafe sleep situations would likely be alive to celebrate their second birthdays.

To implement these recommendations, new mothers need the support of their families and others who care for their children. One of the reasons for the growing disparity between white and black infant mortality rates is the different rate of adoption of these safe sleep recommendations; therefore, getting this message out to the African-American community is essential for its success.

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