IN 1969, the District's infant mortality rate was inordinately high -- about 30 per 1,000 births. During the '70s, there was much improvement. Fewer babies died, and steady progress seemed inevitable. But it hasn't turned out that way. Since 1981 the city's infant mortality rate has been stuck around 20 per 1,000. And the District is not alone.
In a comparison of 20 industrialized nations, the Children's Defense Fund found the United States in last place with the highest infant mortality rate. Nationally, the rate is now 10 per 1,000 births; Japan's rate is six per 1,000. For minorities, the problem has been even worse. In 1980, the U.S. surgeon general set a national goal of cutting the infant mortality rate for minorities and low-income women in half, from 24 per 1,000 to 12 per 1,000, by 1990. As 1988 approaches, despite a number of public campaigns, the figure is still close to 20 per 1,000, and that is unsettling.
What does this tell us? One frustrating answer is that we may be dealing now with the people who are poorest and most discouraged -- the population that is the most difficult to help. A D.C. government prenatal care van, for example, encountered a pregnant heroin addict. The expectant mother agreed to a quickly scheduled appointment for free prenatal care, but never showed up. City officials made six visits to her neighborhood in a fruitless effort to find her again. That's also an example of something else. The D.C. government -- much maligned for poor efforts in the past -- is pulling more of its share in the fight against infant mortality, but it can't win on its own.
Whenever a D.C. ambulance squad is called to treat a pregnant women, it now sends the incident report over to the city's health commissioner. If emergency medical workers can do that, then so can a neighbor, or a church, or a civic association or an advisory neighborhood commission: find those who are pregnant and get them to a clinic for free care. Some of the young fathers and mothers won't be interested or persuaded, but others will. That will give some young children a fighting chance to stay alive. For their sake, we can't afford to be discourage