The report last week that the number of Maryland babies who die before their first birthday dropped to a record low for the second straight year is an encouraging sign that the state's effort to reduce preventable infant deaths are paying off. Those efforts have been especially fruitful in Baltimore City, which for years has had one of the highest infant mortality rates in the state. And while much remains to be done — Maryland infant mortality is still higher than the national average, and stark disparities persist along race and class lines — the fact that infant deaths continue to decline across the state offers hope that even greater reductions are within reach.
Between 2008 and 2011, infant mortality in Maryland dropped 16 percent, to a rate of 6.7 deaths per 1,000 live births. That represents a decline of more than 100 deaths annually over the three-year period, from 617 in 2008 to only 493 last year. (By contrast, the national average was 6.1 deaths per 1,000 births in 2010, the last year for which statistics were available.)
But the most encouraging news was the small but significant decline in Baltimore City's infant mortality rate, which traditionally has been two to three times higher than the overall state rate. Between 2009 and 2010 infant mortality in the city dropped by 19 percent, and it fell another 5 percent last year to a low of 10.5 deaths per live births. The rapidly declining rate in Baltimore City has been responsible for most of the overall drop in the number of Maryland in infant deaths over the last three years.
What these numbers suggest is that health officials' efforts to target outreach and assistance to young mothers in poor and minority communities in Baltimore are working. That, in turn, has raised hopes that similar initiatives in other parts of the state — particularly on the Eastern Shore, where infant death rates remain higher than in Baltimore City and actually rose last year — can achieve comparable results.
Baltimore City health commissioner Dr. Oxiris Barbot credits the city's progress to a long-term public information campaign aimed at the city neighborhoods with the highest rates of infant mortality and to public-private partnerships with hospitals, health clinics and community groups that focus on the risk factors associated with infant deaths. Over the last three years, for instance, the city health department has run a highly successful campaign called B'more for Healthy Babies, which, among other things, encourages expectant mothers get pre-natal care early in their pregnancies, watch their weight, abstain from tobacco and alcohol use and adopt safe sleep practices after their babies are born.
The campaign also is employing some novel public relations strategies to get its message out. To make young fathers more aware of safe sleep practices, for example, the health department partnered with neighborhood barbershops to show a video about how babies should be put to sleep — alone, in a crib, on their backs — to customers waiting to get their hair cut. It's also run the video at the courthouse in the rooms where potential jurors wait to be called for duty. Health department officials are even working with Weight Watchers to encourage pregnant women to eat nutritious foods and avoid becoming obese, a problem closely associated with the risk of low-birth weight babies.
All of these efforts are aimed at using the strengths of institutions that are already operating in the community to change the behaviors that put newborns at risk. It's an ongoing task, and health officials acknowledge they are only part of the multidisciplinary approach that is required, which also includes increasing opportunities for young mothers to get an education and to secure stable employment and housing, all of which play a role in improving health outcomes. That's going to take time, but the city clearly is on the right track to make even greater progress in the future. Other parts of the state should now follow its lead.