infant mortality rate in Baltimore

An article in the Baltimore Sun points out that the infant mortality rate among African Americans in Baltimore City in 2009 was 15.8.  If  we look to the CIA World Factbook table on estimated infant mortality rates in 2010, we find that this suggests that some of the population local to the school of public health at which I work has an infant mortality rate higher than Botswana and other middle and lower income countries.  The article in the Sun pointed out that the infant mortality rate in the county that surrounds Baltimore City is also relatively high, although not as high as in the City.

At least some of this seems to be due to placing infants in dangerous sleeping positions.  The article pointed out that 26 of the children who had died had been in dangerous sleeping postitions.  What would it be worth to save 26 children?  Since we don't know who these 26 will be in advance how much would we be willing to spend to counsel each child's parents and caregivers?  Should we count the lives saved?  Life years saved?  Quailty of life saved?

Regardless of what else could be done to reduce the infant mortality rate in the local African American population, counseling mothers, fathers, and other family members on proper sleeping positions is likely to be a highly cost-effective way of reducing this rate--at least as long as we can convince people to change the way that the children sleep.  Sometimes, despite the fact that people tend to know the facts about a problem, they are slow to change their behavior, even when it can affect a child's health.  The key is to figure out where the resources to try to bring changes in sleeping positions and other issues related to infant mortality will come from; what else individuals and the government may have to be put aside; and what else the parents, local health care providers, and local government need to do to improve infant health in the local population.