Infant Mortality

The Census Bureau reaffirmed this week that Maryland is the wealthiest state in the nation, yet when it comes to the health of its citizens it's almost embarrassingly run-of-the-mill. According to a report this month by an advocacy group that tracks state public health policies and clinical data, Maryland ranked just 21st overall on a list of key health indicators nationally. That's disturbing news, but not nearly as troubling as the reasons behind it. Those reasons aren't hard to find: Although it is home to some of the best primary care physicians and hospitals in the country, the state hasn't done nearly enough to deal with the enormous public health crises that affect its neediest citizens, many of whom are concentrated in urban areas whose problems have long been considered intractable.

Maryland again got a middle-of-the-pack ranking among states for the health of its residents, according to a report issued Tuesday from health research and advocacy groups that looked at a host of government measures and private data. Maryland was unmoved from last year's ranking at 21st by the United Health Foundation, the American Public Health Association and Partnership for Prevention. To make its ranking, report authors assess behaviors, public and health policies, community and environmental conditions and clinical care data.

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.

As the state continues to struggle with a high infant mortality rate that undercuts its relative wealth, Maryland's overall rank in child well-being remained in the middle of the pack nationally, according to an annual report released by the Baltimore-based Annie E. Casey Foundation. The 2010 Kids Count Databook released Tuesday placed Maryland 25th in overall child well-being, the same ranking as a year ago. Although Maryland has the second-lowest percentage of children living in poverty (10 percent)

The state's reported progress in reducing infant mortality is to be cheered, but the fact that infant mortality increased slightly for African-Americans in 2009, and that a smaller percentage of black women received prenatal care that year, should be deeply troubling to public health officials. Persistent racial and class disparities in access to health care are the principal reasons Maryland's infant mortality rate — the number of infant deaths per thousand live births — has remained disturbingly high over the years.

Maryland's infant mortality rate dropped to its lowest point in 2009, according to preliminary statistics, but state public health officials say there is still need for improvement. The overall rate decreased to 7.2 infant deaths per 1,000 live births in Maryland last year, down from 8 in 2008 — a 10 percent decrease. The teen birth rate also decreased, from 2.8 births to women under 18 to 2.6, with declines recorded for black and white women. "We are so pleased this is showing positive progress," said Frances Phillips, Maryland's deputy secretary for public health.

Baltimore officials say they will not use federal stimulus funds for a rally to raise awareness of infant mortality after determining such spending would not be appropriate. Officials are seeking private donations for the event. The decision came after The Baltimore Sun reported that the city planned to spend $17,828.50 in federal money on food and party rentals for a "Fit Family Festival & Rally for Healthy Babies" scheduled for Saturday in Clifton Park. The party, sponsored by the city health department, is expected to cost a total of $40,000, and all of those funds were to have come from the city's share of stimulus grants.

Baltimore's Board of Estimates approved Wednesday spending $17,828.50 in federal stimulus money toward food and party rentals at a rally promoting prenatal health, according to city officials. Mayor Sheila Dixon is to speak at the event, scheduled for Sept. 26 at Clifton Park, according to the Board of Estimates agenda. It is being organized by the city's health department to "raise awareness" about infant mortality in the city and will include "villages" where attendees can receive information about staying healthy while pregnant, financial planning, mental health, nutrition and how to care for an infant, according to the agenda.

This summer, Gov. Martin O'Malley asked the public for suggestions about how to make budget cuts during this time of austerity. Citizens responded with thousands of suggestions, for which they deserve praise. But many of these suggestions also showed little understanding of how citizens can benefit from robust and efficient government services. Maryland needs to better inform its citizens about the many benefits its government provides. Even after the economy improves, Maryland will still face large budget deficits.