By Kay Johnson
Chair, Secretary’s Advisory Committee on Infant Mortality Research Associate Professor of Pediatrics, Geisel School of Medicine at Dartmouth
The Secretary’s Advisory Committee on Infant Mortality (SACIM) was formed in 1991 to advise the HHS Secretary regarding programs directed at reducing infant mortality and improving the health status of pregnant women and infants. The committee represents a public and private partnership designed to provide guidance to HHS and the Health Resources and Services Administration (HRSA). The SACIM work also is intended to focus attention on the policies and resources required to reduce infant mortality.
In July, SACIM members sent a letter to HHS Secretary Sebelius applauding her commitment to develop the first national strategy for reducing infant mortality. In the next few months, SACIM will make recommendations to the secretary to inform and support the national strategy. Work on such a national strategy is at the heart of the SACIM charter.
Over the past year, SACIM members developed and shared a framework with the secretary that calls for a multifaceted effort, including practice improvement by service providers, changes in knowledge, attitudes and behaviors of men and women of childbearing age, improved access to health care, empowered communities, health equity, and a serious commitment to prevention. Actions are needed at the national, state, community, family and individual levels.
SACIM also has called for redeployment of effective prevention strategies, such as breastfeeding, childhood immunizations and family planning. These are basic building blocks for child survival and maternal well-being. Accelerated implementation of the clinical preventive services provisions of the Affordable Care Act (ACA), as well as community-based prevention through public health and social marketing, are needed.
The SACIM framework also emphasizes that the health of the next generation depends upon women’s health. Through the ACA, the United States is on the path to improvements in health coverage for all women. Additional commitment to services and supports for the most vulnerable, low-income women and families also is urgently needed, through programs such as Healthy Start.
The first years of life lay the foundation for an individual and family to be healthy and thrive across the life course. As stated in a recent SACIM letter to Secretary Sebelius: "Our wealthy nation can and should commit to ensuring economic and social support to families so that every baby will be born in optimal health and will enter the world wanted and loved."