December 22, 2006 4:46am CST
Infant Health. At the beginning of the twentieth century, for every one thousand live births, one hundred infants died before age one. Infant mortality began to decline in the early part of the twentieth century, following improvements in urban environments (e.g., sewage and refuse disposal and safe drinking water), milk pasteurization, rising standards of living, and declining fertility rates. The Children's Bureau formed in 1912 called for the establishment of the National Birth Registry in 1915. The Children's Bureau became the primary government agency to work toward improving maternal and infant health and welfare for the next thirty years. In 1935, Congress enacted Title V of the Social Security Act, which authorized and appropriated funds for maternal and child health-services programs. Between 1930 and 1949, infant mortality declined by 52 percent, largely due to antibiotics, development of fluid and electrolyte replacement therapy, and safe blood transfusions. It declined further following the implementation of Medicaid, Community Health Centers, and other federal programs in the 1960s. The Special Supplemental Food Program for Women, Infants, and Children (WIC) was created in 1972. Infant survival continued to improve in the 1970s because of technologic advances in neonatal medicine and the regionalization of perinatal services. Medicaid eligibility for pregnant women and infants was significantly expanded in the 1980s to enhance access to, and utilization of, prenatal care. The development of artificial pulmonary surfactant in the late 1980s and the use of antenatal corticosteroids in the 1990s to prevent and treat respiratory distress syndrome in premature infants also contributed to a decline in infant mortality. Other improvements in infant health in the 1990s include a 50 percent decline in the rates of sudden infant death syndrome, advances in prenatal diagnosis and surgical treatment of birth defects; and national efforts to encourage reproductive-aged women to consume folic acid to reduce the incidence of neural tube defects.