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Infant mortality rate falls Federally funded program credited with giving newborns a better chance Thursday, June 22, 2000 By Sally Kalson, Post-Gazette Staff Writer
The Allegheny County Health Department made a banner announcement yesterday: The infant mortality rate has been cut almost in half in six targeted areas where infant deaths have been disproportionately high.
The drop means that babies in those communities -- the North Side, South Side, central city/Hill District, West End/McKees Rocks, East End/Wilkinsburg and Duquesne/Braddock -- have a better chance of living to celebrate their first birthdays.
The infant mortality rate in the targeted areas is now 10.5 deaths per 1,000 live births, compared to 19.8 deaths in 1988-90, when Allegheny County had one of the highest rates in the nation.
The new rate is still higher than the national figure of 7.2 in 1998, the last year for which figures are complete. It's also higher than the countywide rate of 7.0 in the same year. So officials were quick to stress that their work was far from finished.
"There's still a big racial disparity," said Guillermo Cole, Health Department spokesman, who noted that the six communities combined are two-thirds African-American and one-third white.
The dramatic progress so far is being attributed primarily to Healthy Start Inc., the federally funded, community-based effort designed to reach pregnant women with prenatal services and then follow up with intensive, home-based support for the baby's first year of life.
The goal was to cut infant deaths in half, an accomplishment that is now all but assured.
"It's the community-based aspect that really makes this work," said Carmen Anderson, Healthy Start's executive director.
"We have offices in the community, and our outreach workers live in the communities they serve, so they know the participants and are welcomed into their homes."
Healthy Start workers don't wait for women to come to them. They go out and find them by knocking on doors, visiting hair salons, offices of the federal Women, Infants and Children food program and other places. The goal is to identify women as early in their pregnancies as possible.
Then comes intensive, comprehensive case management, typically going beyond prenatal care to include housing, food and clothing, transportation to school and medical appointments, classes in parenting and child development, even caring for other children.
"My outreach worker was already a family friend, so I trusted her and was open to her," said Melissa McGhee, a 19-year-old mother of two from Fineview. She was attending one of the communitywide baby showers yesterday that Healthy Start stages each year in the six targeted areas.
"She visited me at home every week, schooled me on being a mom and made sure I had rides to all my doctor appointments. She even called me every morning to wake me up and make sure I got to school.
"It really helped a lot," she said. And when her second child, born four months ago, had to be hospitalized for a month, her outreach worker arranged rides to and from the hospital and helped with the care of her older child.
McGhee graduated from Oliver High School last year, thanks in part to her outreach worker's support. Now she has a part-time job helping other teen mothers stay in school.
"We try to get our participants thinking about long-term goals for education and employment," said Health Start's Anderson.
Drug and alcohol addiction are also big concerns for outreach workers, who try to identify substance abusers quickly and connect them to treatment. There's also mentoring support from volunteer "sisters" who have been through recovery themselves.
Healthy Start began in Allegheny County in 1992, a direct response to the alarming news that the county's black infant mortality rate was one of the highest in the nation -- 28.7 in 1989. That number has been dropping steadily each year, down to 15.6 in 1998 -- but still three times higher than the county's white infant mortality rate of 5.2.
So, while Healthy Start has just about met its goal in the six communities, Anderson is under no illusions about how much work remains.
"We're going to have to look at the broader issues of poverty," she said. "Unemployment, poor housing conditions, poor overall health prior to pregnancy, stress -- these things are so difficult to address, but we have to do it if we're going to continue our progress so far."
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