Baltimore

So, Baltimore. Where the infant mortality rate is 13 per 1000 births. Just to put that in some kind of perspective, across the US the rate is 6.06 per 1000 births. In Australia it's 4.61 per 1000 births and even in our Aboriginal population it's 4.4. The measure of infant mortality is the pulse, blood pressure and temperature of a nation's health. So what's going on in Baltimore? Well, in only a few hours I wasn't going to pick up on all the social and cultural nuances but there are a few clues. For a start, 65% of the population is African American, a population who continue to be a disenfranchised, disempowered and extremely disadvantaged. They lack money, education and opportunity. There are more teen mums, more drug use, more alcoholism. In the naughties - studies found that the infant mortality rate was due to low birth weight babies which could be directly attributable to lack of prenatal care, malnutrition, lack of calcium, folic acid, magnesium and iron. African American women tend to not to breastfeed and a lack of proper bedding and information about safe sleep practices made babies more susceptible to SIDS. Campaigns across the States had a big impact on reducing SIDS amongst the white American population but the rates amongst African Americans remained

unchanged - what does that tell us about the social marketing campaigns?

It's not an unfamiliar story is it? Our disenfranchised communities; the Australian Aborigines, the Canadian First Nations, The New Zealand Maoris, The British travelling gypsies . . . anyway I'm getting off my point but it's important that the back drop hung correctly in case the story is skewed.

Baltimore - so I'm there with the Baby Basics project whose resources have become central tools in supporting "home visitors" to provide women with information and to engage them in their prenatal care. We visit a "Healthy Family Site", a community based organisation which is one of 16 sites in Maryland. They are set up to serve the needs of the neighbourhoods that need them. Charlene, one of the workers describes Baltimore as a city of neighborhoods, with each having its own distinct culture and issues.

The service is funded by the Family League, which is a quasi-government organisation that receives funding from the State government to distribute to healthy family sites.

In recent times, the sites are being asked to transition to a more evidence based model than they have been using in the past. And without fuss they have; adopting relevant practices and paperwork and forms and tools.

Baby Basics is here in Baltimore to see how the project is working here. They are concerned that the Baby Basic philosophy is being adopted - not just the book. Is it being "actively" delivered, are women being encouraged to use their planner, to jot down their questions independently or with help from their peer support worker? Is literacy being supported in the delivery and use of the product?

Baby Basics is a winner here. The workers tell us that women think of it as a "gift". It's often the first book that women have owned for many years and in it is information that switches women on to the idea of learning and yes, reading, or at least flicking through to look for images and small pieces of accessible text.

Infant mortality is reducing in Baltimore. A targeted social marketing campaign, a supply of cribs for families who can't afford them, an aggressive family support program see to be having an impact - though the hows and whys are still being figured out. The journey of the Baby Basic program in Baltimore will be fascinating to watch, I look forward to hearing more about it in time.