Healthier beginnings

What the world can learn from Pittsburgh

Monday, September 14, 2009

By Bill Frist

When world leaders chart a course toward a more prosperous future at next week's G-20 summit, Pittsburgh can inspire in more ways than one.

The city built on steel has renewed its shine as a center for research and technology and become a model for economic comeback. When this recession recedes, Pittsburgh is poised to jump far ahead of cities where "rust belt" still rings true.

But progress is not measured solely in economic terms. Presidents and prime ministers should note a different kind of progress that Pittsburgh pursued and achieved in the years it was still building its first boom. This kind of progress has yet to reach many parts of the planet, but, in the interests of all, must.

Sustainable recovery and long-term economic growth depend on improving the well-being of the world's most vulnerable people and ensuring they, too, participate in recovery. To that end, improving the health of children and mothers is fundamental.

In 1920, Pittsburgh had the worst recorded infant mortality rate of any large U.S. city. Some of the oldest residents of Pittsburgh today started life with the same odds of reaching their first birthday as newborns in Somalia do now. One in nine babies died.

Several other cities also had dismal records, but Pittsburgh's last-place ranking prompted the federal government to make a case study of the city. After World War I, the United States had recognized that resilience and continued growth depended on healthy babies who would grow into strong, productive adults.

In "Infant Mortality in Pittsburgh," the Children's Bureau of the U.S. Department of Labor recorded diarrhea and pneumonia as the most-common infections killing babies in Pittsburgh. Remarkably, despite decades of medical advances and low-cost, easy-to-administer treatments, this still holds true in the developing world.

The study also noted that nearly half of Pittsburgh's infant deaths occurred in the first month of life from prenatal or birth-related causes. Today, this remains by far the most dangerous month of life in poor countries. Nearly 4 million newborns die every year, half on the day they're born.

In analyzing Pittsburgh nearly 90 years ago, the Children's Bureau wrote that most newborn deaths had already been "clearly demonstrated" to be "largely preventable." Yet, the kind of basic health services and practices that Pittsburgh subsequently embraced are still lacking in many countries today.

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