Alaska experts urge safe sleep practices to combat rise in infant deaths – Alaska Public Media

Report on Rising Infant Mortality in Alaska and its Implications for Sustainable Development Goals

1.0 Executive Summary

A November report from the State of Alaska indicates a significant increase in the post-neonatal infant mortality rate since 2017, a trend that directly challenges the achievement of key United Nations Sustainable Development Goals (SDGs). With over 500 infant deaths in the past decade, Alaska’s rate now surpasses the national average. The majority of these deaths are sudden and preventable, highlighting an urgent need for interventions aligned with SDG 3 (Good Health and Well-being), SDG 10 (Reduced Inequalities), and SDG 1 (No Poverty).

2.0 Analysis of the Public Health Crisis

The rising infant mortality rate represents a critical public health issue with direct relevance to global development targets. State analysis reveals several key data points.

• Mortality Trend: A steady decline in infant deaths ended in 2012, with a significant rate increase observed from 2017 onwards.
• Nature of Fatalities: Most infant deaths are categorized as sudden and are not attributable to pre-existing medical conditions.
• Comparative Rate: Alaska’s infant mortality rate is now higher than the U.S. national average, indicating a significant regional disparity.

3.0 Linkage to Sustainable Development Goals (SDGs)

This issue is intrinsically linked to several SDGs, demonstrating a localized failure to meet global standards for health and equality.

• SDG 3: Good Health and Well-being: The increase in preventable infant deaths is in direct opposition to Target 3.2, which aims to end preventable deaths of newborns and children under five years of age. The recommended interventions, such as immunizations and safe sleep practices, are fundamental to achieving this goal.
• SDG 10: Reduced Inequalities: The disparity between Alaska’s infant mortality rate and the national average underscores a failure to meet Target 10.2, which promotes the social and economic inclusion of all. Addressing this gap is essential for ensuring equitable health outcomes.
• SDG 1: No Poverty: The provision of resources for families to acquire safe cribs points to underlying socioeconomic factors that contribute to infant mortality. Unsafe sleep environments can be a consequence of poverty, linking this health crisis to the broader goal of poverty eradication.
• SDG 16: Peace, Justice and Strong Institutions: The role of the state’s maternal child death review program exemplifies the function of strong institutions in monitoring public health. Effective data collection and analysis are crucial for developing policies that protect vulnerable populations and uphold the principles of SDG 16.

4.0 Recommended Interventions for SDG 3.2 Attainment

State health officials have outlined several evidence-based, preventable measures that are critical for reducing infant mortality and advancing SDG 3. These recommendations focus on creating safe environments and promoting healthy practices for infants.

1. Establish a Safe Sleep Environment: This is the most critical factor in preventing sudden infant death.
   • Infants must sleep alone and on their backs.
   • Sleep space must be a crib with a firm mattress.
   • The crib must be free of all soft items, including pillows, stuffed animals, and fluffy comforters.
   • Couches and recliners are explicitly identified as unsafe sleep locations.
2. Ensure Sober and Unimpaired Caregiving: A sober, unimpaired adult must be responsible for the infant at all times. This includes caregivers who may be using prescribed pain medication or other impairing substances.
3. Implement Supportive Health Practices: Additional measures are proven to reduce the risk of infant death in the first year.
   • Breastfeeding
   • Adherence to routine immunization schedules
   • Use of a pacifier during sleep

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The primary Sustainable Development Goal (SDG) addressed in the article is:

• SDG 3: Good Health and Well-being

  The entire article focuses on the rising infant mortality rate in Alaska, which is a core health issue. It discusses the causes of these deaths, preventative measures, and the overall goal of reducing infant fatalities to ensure babies live healthy lives. The article’s central theme of preventing infant deaths and promoting safe practices for babies aligns directly with the objectives of SDG 3.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article’s discussion of infant mortality and its contributing factors, the following specific targets under SDG 3 can be identified:

• Target 3.2: End preventable deaths of newborns and children under 5 years of age

  This target is directly relevant as the article highlights a significant increase in the “rate of post-neonatal infant mortality” in Alaska. The focus on preventing deaths from non-medical causes, such as unsafe sleep environments, directly supports the goal of ending preventable deaths of young children.

• Target 3.5: Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

  This target is connected through the article’s emphasis on the need for a sober caregiver. The research analyst, Marley Elconin, explicitly states the importance of a “sober caregiver… at all times” and notes that impairment can come from pain medication or marijuana (“if mom just had a C-section and she’s taking pain meds, we consider that impairment… someone else who hasn’t smoked weed or is taking any medication”). This points to the prevention of harm related to substance use as a key factor in reducing infant mortality.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article mentions and implies several indicators that can be used to measure progress:

• Indicator for Target 3.2 (Infant Mortality Rate)

  The article explicitly uses the infant mortality rate as a key indicator. It states, “The rate of post-neonatal infant mortality has increased significantly in Alaska since 2017” and that “Alaska’s infant death rate is now higher than the national average.” The raw number of deaths (“More than 500 infants have died in Alaska in the last decade”) is also mentioned, which is the data used to calculate this rate. This is a direct measure of progress (or lack thereof) towards Target 3.2.

• Implied Indicators for Prevention

  The article implies several behavioral and practice-based indicators that measure the adoption of preventative measures. Progress could be tracked by measuring:

  • Prevalence of safe sleep practices: The article details specific safe sleep recommendations, such as a baby sleeping “alone on their back… in a crib” without “stuffed animals or a fluffy comforter.” Tracking the percentage of families following these guidelines would be an indicator of prevention efforts.
  • Breastfeeding rates: The article mentions that “breastfeeding” can help prevent infant death, implying that tracking breastfeeding rates would be a relevant indicator.
  • Immunization coverage: The mention of “routine immunizations” as a preventative measure suggests that immunization rates among infants are another key indicator.
  • Incidence of infant deaths related to caregiver impairment: The strong emphasis on the need for a “sober caregiver” implies that tracking the number or proportion of infant deaths where caregiver substance use was a factor would be a critical indicator for measuring progress related to Target 3.5.

4. Table of SDGs, Targets, and Indicators

Source: alaskapublic.org