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B'More Babies

Alicia Buelow

Turning the Tide

Can a new campaign that emphasizes collaboration and communication save infants’ lives in Baltimore?

Last year, 128 infants died in Baltimore City. Those deaths translate to a 2009 mortality rate of 13.5 deaths per 1,000 live births—a rate more commonly seen in a developing nation, not a city that’s home to Johns Hopkins Hospital and almost a dozen other major medical facilities.

Baltimore’s tragic deaths reflect faltering national efforts to continue reducing infant mortality, particularly in disadvantaged communities. “From ages 1 to 5, our mortality rate really isn’t very different from other countries’,” says Bernard Guyer, the Zanvyl Krieger Professor of Children’s Health. “Our big problem is that, compared to [other] developed countries, the United States has a lot of very small babies, and a very high rate of preterm births.”

The percentage of preterm births in the U.S. has increased by 36 percent since 1984, according to the National Center for Health Statistics (NCHS). Those high-risk births increase the risk of death within a year (infant mortalities are those that occur before one year of age). Between 1960 and 2005, the U.S. infant mortality ranking in the world fell dramatically, from 12th to 30th, NCHS reported last year. Though the U.S. has reduced its infant mortality rate from 26 deaths per 1,000 live births in 1960 to 6.9 in 2005, other countries’ rates have fallen faster. In fact, the U.S. infant mortality rate did not decline significantly from 2000 to 2005.

On December 29, 2009, Dearea Matthews’ 1-month-old child, Charlie, died while sleeping beside her. After her agonizing loss, Dearea joined the B’More for Healthy Babies campaign. “No other mother should have to go through this,” she says.

The news isn’t all bad on the domestic front. In Maryland, for instance, the overall infant mortality rate actually fell between 2008 and 2009, from 8 to 7.2 deaths per 1,000. While much of the state has a low rate, several areas of very high infant mortality increase the statewide numbers. Two areas—Prince George’s County and Baltimore City—account for more than 40 percent of the state’s infant deaths. That’s largely because many of their communities are beset by poverty and a lack of connections to good prenatal health care.

But the unveiling of a new campaign that launched in Baltimore this August may just turn the tide on those disturbing infant mortality rates—and serve as a model for urban areas across the nation. The program has public health workers like Guyer, a veteran child health researcher and advocate, optimistic. “I’m really enthusiastic about what’s going on,” he says. “We’ve just put up with this for too long.”

The three-year B’more for Healthy Babies program is an intriguing mix of proven strategies, new approaches and focused communication programs. It targets the communities of Patterson Park North and East, Upton/Druid Heights and Greenmount East, some of the places where infant mortality strikes hardest, and most of which are predominantly African American; 95 percent of the city’s 128 infant deaths in 2009 were in African-American families.

The $7.5 million program involves a formidable collaboration of agencies and resources, notes Guyer, MD, MPH. Partnering organizations include the Baltimore City Health Department, the Family League of Baltimore City and CareFirst BlueCross BlueShield (which donated $3 million). Bloomberg School faculty and staff have been involved from the early stages, and are now contributing to the program’s implementation.

“In 20 years,” says Guyer, “this is the biggest political commitment to these issues I’ve seen.”

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