Thursday, August 25, 2011

Baltimore Sees Reduction in Infant Mortality

Yesterday, I had the privilege of joining Governor Martin O’Malley, Lt. Governor Anthony Brown, DHMH Secretary Dr. Joshua Sharfstein, Baltimore City Mayor Stephanie Rawlings-Blake, and our community partners at the University of Maryland School of Social Work for an important announcement regarding infant mortality in Baltimore City.

Baltimore has struggled for years with high rates of infant mortality, and the reality is that this rate had been growing. I am pleased to report that last year, infant mortality dropped by 19 percent in Baltimore City. Of this, there was a 40% reduction in infant sleep related deaths in Baltimore. Eleven fewer babies died from sleep-related causes as compared to the previous year. While that number may not sound big, it means the world to families affected by these preventable deaths.

There are some who would argue that this reduction is due to a statistical cycle and does not reflect outcomes due to a particular intervention.  While we are cautiously optimistic that that is not the case, we are confident that these numbers are going in the right direction and that our ongoing efforts will continue to drive down the curve and reduce racially-based disparities.

Two years ago, the Health Department, together with the Family League of Baltimore City, charted a course forward through the B’more for Healthy Babies campaign using data we collect about all infant deaths. This campaign, which has 3 phases, is providing education and outreach to mothers, fathers, grandparents and other caregivers to make sure they know the safest way to take care of babies.

Last year the Mayor helped launch the first phase of the campaign by issuing a safe sleep proclamation: Healthy Parenting. Through our community partnerships, our Sleep Safe video is being shown in all eight of the city birthing hospitals, in the jury assembly room, and at intake at the Eager Street prison. These are non-traditional ways of delivering life saving public-health messages. Additionally, we have trained over 1,600 service providers, including DSS workers, community care givers, and health professionals in the ABC’s of safe sleep.

In the next few months we will launch the second phase of the B’More for Healthy Babies campaign. The focus will include family planning, early entry into prenatal care, and smoking cessation. The third and final phase will focus on the importance of good health on a person’s ability to lead life to the fullest and to have healthy babies.

It’s so important for parents to be educated about how to take care of their newborns. That begins with pregnant women and mothers taking care of themselves – by eating healthy and not smoking or drinking. Fathers can also contribute by learning how to put babies down safely. And nobody should smoke around pregnant women and infants; the health risks from second-hand smoke are real.

Today, we’re happy to report progress on one of these important issues, and it’s always good to share some good news. But there’s plenty of work to be done.  The fact remains: far too many children under the age of one are dying in our city, and many of these deaths are preventable. Baltimore is determined to do everything it can to reduce – and eliminate – preventable infant deaths. This starts with each one of us acting on what we can contribute. Together we can make a difference.

Tuesday, August 23, 2011

Health Department Hosts Blood Drive

As a physician, I am keenly aware of the importance of maintaining a well supplied blood bank. Everyday here in Baltimore and across the world, lives are saved by donated blood. For this reason, donated blood is worth its weight in gold – and then some.

So to waste a single drop is unthinkable.

Recently, Maryland Lt. Gov. Anthony Brown announced the Maryland Blood Wastage Collaborative, an innovative solution for reducing blood waste throughout the state by improving institutional coordination to ensure no blood inventories are allowed to expire. This supports not just individual health, but public health as well.

The Mayor and I encourage our neighborhood leaders to consider hosting a community blood drive and encouraging others to donate through word of mouth, community or church newsletter articles, and other available means.

Today, the Health Department is hosting a blood drive at
1001 E. Fayette Street
from 9 a.m. to 3 p.m. It is open to the public and walk-ins are accepted. If you live or work nearby, I encourage you to stop in and make a donation. Donors will receive a “Be Extraordinary” T-shirt from the Red Cross.

Ultimately, the decision to donate is up to you. Help us help those in need by giving blood.

Wednesday, August 3, 2011

Meeting People Where They Are: The Needle Exchange Program

The best outcomes in public health often happen when we meet people where they are.

Our NEP staff - Chris Serio-Chapman, Derrick Hunt and Lamont Clark.
At 10 a.m. this morning, I witnessed a part of life that many of us shy away from.  I spent time observing the work Health Department staff do within our harm reduction program.  Within the confines of a small camper on a street corner in Southwest Baltimore, two staff members attended to drug injecting users exchanging dirty needles for clean ones.  There was a steady stream of clients – men, women, young, old, black and white.  Some were regulars who chatted for a bit and then went about their day, while others were in and out in less than five minutes.
One of the clients, a woman just a year older than me, shared she had ongoing liver disease, diabetes and MRSA.  She also shared symptoms that made us suspect her diabetes was not under control and we convinced her to follow up with her clinic.  Another young lady listed a bunch of STI’s she had been treated for and was concerned she might have HIV.  We were testing her for HIV on the spot.

Our Needle Exchange Program (NEP) is the cornerstone of BCHD’s Ha­­­rm Reduction Program. NEP is an evidenced-based intervention program that provides clean needles to injection drug users in return for used syringes, which are discarded. The purpose of the program is to reduce the frequency of infections passed through the use of unclean needles, infections that include HIV and hepatitis C. 

The time I spent on the van gave me a more personal glimpse of the ravages of drug abuse in our city.  Our program, run by Chris Serio-Chapman and her staff, is the only confidential needle exchange program in the country.  The success of the program has been documented: when the program began in 1994, it is estimated that approximately 650 incident cases of HIV in Baltimore were caused by injection drug use, representing 60.3% of reported HIV.  Sixteen years later, the number of new HIV infections caused by injection drug use dropped to 177 new cases per year, representing a 29.5% decrease in the proportion of new HIV diagnoses caused by injection drug use.

One of the many reasons we’ve been successful is the attention paid to doing things that are evidence-based and evaluating the work we do to make sure we’re getting the outcomes that will best improve the lives of the people we serve.  An even more important reason is the dedicated staff that we have.  In addition to Chris, I got to talk with Derrick Hunt and Lamont Clark about their experience with the program and how we could help people on the road to recovery. 

I also had the pleasure of observing the skill with which they were able to engage individual clients by meeting them where they were. NEP has been extremely successful in this regard, currently operating at 17 locations around the city. Since 1994, more than 9 million clean syringes have been distributed to clients, and more than 10 million contaminated needles have been properly destroyed since it was started.

For more information about Baltimore’s needle exchange program, including our location sites and times, please see our website. For the latest NEP updates, be sure to “like” their Facebook page.

Take Care, Baltimore.