City losing ground on child health Group urges sweeping changes in laws, programs.


Baltimore is losing ground in almost all areas affecting children's health, according to a local advocacy group that has compiled a report on the health problems facing local children.

Advocates for Children and Youth Inc., which wants sweeping changes in state laws and more funding for children's programs, today released a 60-page compilation of grim facts, ranging from the city's high infant mortality rate to the overworked nurses who staff city schools.

Although most of the figures have been released previously in other reports, "Baltimore's Unhealthy Children: Is There a Doctor in the House?" represents the first attempt to link the problems, then follow them up with concrete proposals.

The local report, which advocates spending millions in additional funds for children's issues, comes just days after a national task force recommended that $56 billion be spent on child-related concerns.

Susan P. Leviton, president of Baltimore group, said she hopes this emphasis on children will be inspiring, not numbing.

"You get into this whole issue of: We have these reports, and then what happens?" Leviton said. "The only thing I can say is five years ago we weren't bombarded every week by a new report about kids. I have to think that people eventually are going to say, 'We have to do something.' "

Solutions proposed in the report include: providing Medicaid coverage to 6- and 7-year-olds, increasing the use of home visiting programs for high-risk pregnant women, spending $2 million more on family planning services targeted at teens, and hiring school nurses for the state's poorer jurisdictions.

The report does detail some recent successes, including the development of health standards for the state's public schools. A 34-year-old law stipulated the creation of such standards, but it was only in March of this year that the State Board of Education complied.

However, infant mortality and low-birthweight babies, were cited two of the city's most pressing problems, especially when compared with national objectives set for the year 2000.

"A child born in Baltimore is 1.5 times more likely to die in his/her first year of life than a child in another area of our state, and 2.5 times more likely to be born to a teen-age mother," the report states.

The city has one of the highest mortality rates in the country for all children, and the highest rate for white infants.

Although the rates, which are calculated according to the numbers of deaths per 1,000 births, dropped from 1975 through the early 1980s, the numbers began to climb again. By 1987, the last year for which the report has statistics, there were almost 20 deaths for every 1,000 births, a rate worse than some developing countries.

Meanwhile, low birthweight -- defined as any infant below 5.5 pounds -- occurs twice as often in Baltimore as it does in the rest of the state, the report notes. More than 12 percent of Baltimore babies born in 1987 were underweight.

Low birthweight is considered significant because it often is a contributing factor in infant mortality. And those infants who survive are more vulnerable to illness.

Home visiting programs have helped some Baltimore women overcome the problems associated with high-risk pregnancies, the report says. But those programs often are underfunded, so that the workers reach only a small percentage of those women who would benefit.

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