Making Government Work

How Maryland Decreased Its Infant Mortality Rate in Record Time

April 3, 2014
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How Maryland Decreased Its Infant Mortality Rate in Record Time
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It all comes down to numbers, education, and some hyper-focused regional attention.

People knock local governments for bureaucracy and red tape, but Maryland deserves an equal amount of fanfare for its data-driven — scratch that, successful data-driven — push to lower the statewide infant mortality rate.

With his state’s numbers well above the national average, Governor Martin O’Malley managed to lower it two separate times, both ahead of schedule. In 2007, he set five-year deadline to reduce Maryland’s infant mortality rate by 10 percent. When that goal was achieved a mere two years later, with 8 fatalities per 1,000 live births down to 7.2, O’Malley honed in on the main area of concern: The continued-high numbers of African Americans dying in infancy. Again, he aimed for a 10 percent reduction, this time by 2017. Finding success again, he reached that milestone five years early.

The fruits of O’Malley’s efforts are easy to see. According to Governing, between 2011 and 2012, the state’s infant-mortality rate among African-Americans declined by 14 percent, to 10.3 per 1,000 live births. Also in 2012, Maryland’s infant mortality hit a record low of 6.3, down by 21 percent since 2008 and about the same as the national rate for 2012.

How did O’Malley manage do this so hyper-effectively? It all comes down to data. O’Malley tasked the state’s health serves to identify and funnel resources into areas with the highest infant-mortality rates. Two areas, Prince George’s County (which lies just east of Washington, D.C.) and Baltimore, demanded the most attention.

Baltimore, the state’s largest city, had some of the most grave infant-mortality issues. To address these problems, the state worked with local organizations like B’more for Healthy Babies, which is led by the city’s health department. For instance, B’more’s Sleep Safe initiative uses the media, community outreach and provider education to reduce sleep-related deaths. With the second leading cause of death among city infants being preventable sleep-related complications, this was proof of targeted problem-solving.

In-home education and social services for pregnant women and new mothers also were cornerstones of the Baltimore initiative. The city’s infant-mortality rate has dropped every year since B’more for Healthy Babies began in 2009, falling by 28 percent from 2009 to 2012, Governing reports. In 2012, Baltimore’s infant mortality for the first time fell below 10 per 1,000 live births. Notably, the disparity between African-American and white infant-mortality rates declined by 40 percent during that time.

Prince George’s County saw the creation of a similar “Healthy Women, Health Lives” program that took a comprehensive approach to the overall health of women of childbearing age.

Governing makes a point of noting how a lower infant-mortality rate is good for more than just immediate families.

Infant mortality is far more common among premature, low-birth-weight (LBW) and very-low-birth-weight (VLBW) babies. Including the costs of delivery-related hospital stays, transfers and readmissions, the expenses for a normal-birth-weight Maryland baby totaled $8,703 in 2009, compared to $45,543 for an LBW baby and $239,945 for a VLBW baby. As the number of LBW and VLBW babies declines, the health-care savings help pay for the resources used to reduce infant mortality overall.

The B’more for Healthy Babies and Healthy Women, Healthy Lives programs focus on both education and health resources. As the state’s Department of Health and Mental Hygiene realized that many uninsured women were delivering babies without any prenatal care, they charged local health departments with implementing a program called “Quick Start.” This allows uninsured women to get timely prenatal care appointments while awaiting Medicaid eligibility determinations.

With better prenatal care comes better-informed mothers and healthier babies. Call it a win-win.

 

 

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