RAND economist Evan Peet had spent his career working to improve infant and child health in developing nations around the world. He was stunned when he saw the numbers coming out of Pittsburgh.

Black babies in the city's most marginalized neighborhoods were dying at rates similar to those he had seen in Nicaragua and the Philippines. Babies in America—and especially Black babies in America—die before their first birthday at some of the highest rates in the developed world.

Peet and other researchers in Pittsburgh set out to do something that had never been done before. They linked birth-certificate information from tens of thousands of babies with electronic health records, social service registries, and neighborhood data points such as poverty rates and air-quality readings. Their goal was to account for every risk factor facing every newborn baby—and to identify the services and supports that would give that baby the best chance to thrive.

“You read about initiatives all over the world to reduce infant mortality by teaching parents about safe sleep or providing them with baby products,” said Peet, a health economist who helped lead RAND's team. “Those may be helpful in some instances, but they're not going to address what's really driving these numbers. For that, we need to look at racism, poverty, these systemic disparities in health and health care.”

“That individual-level data, linking mothers and infants across all these different databases, that's completely novel,” RAND's Peet said. “It's a huge lift. But the earlier you can identify someone at risk, the earlier you can get them the services they need, and the more lives you can save. Every single intervention we looked at was more effective the earlier it started. Every single one.”

Read the full article about helping babies in marginalized neighborhoods by Doug Irving at Rand.