Panel Calls for U.S. to Curb Infant Deaths : Health: Final report says the mortality is a preventable social problem, not a medical one. More prenatal care for blacks is urged.

The National Commission to Prevent Infant Mortality, which has run out of funding, issued a final report Wednesday calling on the nation to remedy a surprisingly high infant death rate that gives the United States one of the worst records of any developed country.

Florida Gov. Lawton Chiles, the commission’s chairman, said six years of work by his panel has shown that the death of infants “is not so much a medical problem as it is a social problem . . . that is preventable.”

He recommended that more efforts be directed to prenatal care for “inner-city families,” where the death rate for black babies under 1 year of age is more than double that of white babies and has caused the United States to rank 21st among developed countries.

Until Congress refused to authorize funding for the commission, which will expire Dec. 31, the panel worked with private organizations and community groups to provide counseling to poor, young expectant mothers, to direct them to prenatal clinics and to show them how to care for young children, officials said. It served as a national study and resource center to promote the well-being of expectant mothers and small children.

Chiles said the 16 members of the commission unanimously believe that Congress must rate prenatal and infant health as “a national priority” in any health care reform plan it adopts next year. He commended President Clinton and First Lady Hillary Rodham Clinton for “their commitment to universal access to prenatal and pediatric care.”

“Everyone must have access to both health insurance and medical services. We need to do more to put our money and effort on the front end during the prenatal period.”

But, speaking as a governor, Chiles said that “Congress, in addressing health care reform, must allow states the flexibility to meet their needs.”

The commission said the latest mortality figures show that 8.9 American infants of every 1,000 die during their first year. That is worse than most European nations, Canada, Japan, Hong Kong and Singapore. Only Greece, Portugal and Israel have poorer rankings, all with 10 infant deaths per 1,000, officials said.

Citing statistics compiled by the U.S. Centers for Disease Control and Prevention, the commission said the rate for white children was 7.3 per 1,000 in 1991, the last year reported, but mortality among African Americans has remained virtually unchanged in recent years at 17.6 infants per 1,000.

Congenital disabilities were the leading cause of death among white infants, whereas low birth weight ranked as the principal cause of death among black babies, officials said. They said poverty is largely to blame for higher mortality rates among blacks, particularly among families that have limited access to medical care and are not covered by health insurance.

The commission said that the overall infant mortality rate is improving but that this is attributable “to expensive neonatal technology that saves smaller and sicker newborns” and “not to preventing the problems in the first place.”

It said prenatal care is essential to solving the problem.