Health Campaign in 2 Poor Areas of San Bernardino Cuts Infant Mortality Rate

Mirroring progress that has been seen across California, San Bernardino County health officials announced Monday that a four-year campaign to tackle alarmingly high rates of infant mortality and improve children’s health has been a marked success.

The worst problem had been in two urban neighborhoods in the city of San Bernardino that are home to 66,000 people and troubled by poverty, low education and poor prenatal care. There, in the mid-1990s, nearly 15 of every 100 pregnant women used illicit drugs, four of 10 residents were on welfare, and more than one in 100 infants died before their first birthday.

The communities, in ZIP Codes 92410 and 92411, were ground zero for San Bernardino County’s alarmingly high rate of infant death--one of the worst in California. Overall, the county’s infant death rate was 11.8 per 1,000 births from 1993 to 1995, compared with the statewide average of 6.4 during roughly the same period.

But health officials said Monday that they have made significant strides in improving the health of infants in those neighborhoods.

Armed with $8 million in federal funds, a campaign known as Healthy Start II showed dramatic results for 1998 and 1999, the first two full years of the program. Similar programs have been started in 95 communities across the country, from Honolulu to Los Angeles to Tallahassee, Fla.

Compared with figures for 1993 to 1995, the percentage of premature births in the two neighborhoods dropped by 6.9% and the percentage of mothers who received prenatal care within their first trimester increased by 18.7%.

Most significant, in those two ZIP Codes the rate of infant deaths--those occurring before a child’s first birthday--fell 35%.

Evelyn Trevino, a statistician for the San Bernardino County Department of Health, said Monday that the drop means that 25 babies who would have died before their first birthday, had they been born seven years ago, are alive today.

The county as a whole still has work to do; overall, its infant death rate did not change from 1993 to 1999.

But the progress reported in the two most troubled ZIP Codes had health officials upbeat Monday.

The county has made such significant strides that it is no longer eligible for the federal funds that paid for Healthy Start II, and it will have to search elsewhere for funding to continue and expand the campaign, said Vanessa Long, program manager of San Bernardino County’s Maternal Health Section.

“It’s really satisfying to know that when the community pulls together, we can accomplish something--and we can accomplish something great,” Long said. “Our experience here can be a start.”

The campaign included a variety of outreach programs.

Officials organized community forums for new mothers and sent community leaders and health professionals to homes.

One doctor in the 92411 area, after learning through the campaign about the importance of screening for bacterial vaginosis, began regularly checking his patients, Trevino said. The common infection is linked to premature labor, and the doctor’s efforts helped reduce the incidence of premature births among his patients from 16% to 10.7%.

The program also included intervention programs encouraging women to space out their pregnancies, and turning them from drugs.

“They had an army out there doing outreach,” Trevino said.

Health officials also reported a significant improvement in the health of African American children in the study area.

Last spring, California reported similar success in lowering death rates among African American infants. Statewide, there were 19.2 deaths per 1,000 births in 1989, a figure that dropped to 13.2 by 1997.