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Report Seeks New Spending To Cut Infant Mortality

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WASHINGTON--The United States should dramatically increase spending to reduce its infant-mortality rate, the draft of an unreleased White House report recommends.

The draft, completed by the White House Task Force on Infant Mortality but distributed by the Children's Defense Fund, states that the country already possesses the knowledge needed to save an additional 10,000 infant lives a year and to protect another 100,000 newborn children from preventable disabilities.

The report calls for hundreds of millions of dollars in additional spending for the effort, including more than $800 million over the next four years in combined state and federal funds to expand the Medicaid program.

The task force, which was formed in July 1989, includes members from 10 federal departments and agencies and 6 White House offices. The group was charged with finding ways to reduce the country's infant-mortality rate, which, according to the U.S. Department of Health and Human Services, currently ranks 22nd among industrialized nations.

About 40,000 infant deaths occur each year, or 9.7 out of every 1,000

live births. Nearly 18 of 1,000 black newborn children die each year before their first birthday, about twice the rate of infant deaths among whites.

The CDF began distributing the report after some questioned whether the White House was putting the report on hold in order to avoid political embarrassment.

For instance, in a letter last month to Dr. Louis W. Sullivan, the Secretary of Health and Human Services, Representative John D. Dingell, Democrat of Michigan, said that "certainly, the disclosure of [the Medicaid] recommendation would highlight the fact that President Bush has reneged on his October 1988 campaign promise to expand Medicaid coverage for pregnant women and infants up to 185 percent of the federal poverty level."

A spokesman for President Bush said no date has been set for the release of the final report.

"[Panel members] are still in the process of coming to some agreement that everyone can be happy with," she said.

According to the draft report, many of the social, environmental, biomedical, and behavior factors tified as the major causes of infant mortality can be addressed either before or early in pregnancy.

"Infant death and disability are not intractable problems," the report says.

The report notes that the lack of private health insurance is one of the most serious barriers to health care. About 9 million women of childbearing age have no health insurance, the report says, and Medicaid does not cover many poor women and children.

To reduce the infant-mortality rate, the report recommends:

Requiring states to expand their Medicaid programs to all infants and pregnant women from families with incomes below 150 percent of the federal poverty level, up from the 133 percent level now covered;

Funding 20 large-scale community-based initiatives to reduce infant-mortality rates;

Expanding and simplifying eligibility for federal programs, such as food stamps and welfare;

Expanding programs to reduce smoking, drinking, and drug use among pregnant women; and

Encouraging the establishment of school health-education programs that focus on pregnancy prevention and the need for prenatal care.

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