Infant Mortality: Our Past, Present & Future Albatross
By Phyllis J. Sloyer, RN, PhD, FAHM, FAAP
Despite research, funding, and practice, we certainly can’t claim U.S. infant mortality rates to be our hallmark of success. While we did dramatically reduce these rates in the 20th century through a series of technological advances, we can’t claim that we have continued progressively reducing our rates. In fact, we know that there are multiple issues impacting the rates, including all of the social and environmental threats we face; threats of poverty, poor nutrition, unsafe neighborhoods, environmental hazards, impediments in our health care delivery system, lack of supportive families and other variables that are the ingredients in a volatile recipe for increased infant mortality.
This issue of Pulse will explore some of those variables and provide examples of promising practices. While we begin to look at interventions that address some of the social and environmental detriments to a healthy outcome, we must also recognize that the health care delivery system has changed. Many of us remember the successes of regionalized perinatal care and have watched the evolution or devolution of regionalization. New ingredients have been added to the mix, including various models of managed care and the principles inherent in balancing cost and quality. Future policies that address infant mortality must be based on a formula that attends to the social, economic, environmental variables influencing individual health plus the organization, financing, and management of health care delivery systems.