November 17, 2005

Widening social inequality seen in SIDS risk in US

By Megan Rauscher

NEW YORK (Reuters Health) - A study of the effects of the
nationwide 'Back to Sleep' campaign -- an initiative launched
in 1994 to encourage mothers to place their babies on their
backs rather than their stomachs to sleep -- shows that this
campaign has helped to reduce sudden infant death syndrome
(SIDS) cases overall in the United States.

The campaign has not, however, reduced SIDS to the same
extent in all levels of society.

On the contrary, "the social gap in inequalities among SIDS
deaths widened," Dr. Kate E. Pickett, from the department of
health sciences at the University of York in England, told
Reuters Health. "The race disparity in SIDS also increased
after the campaign," she added.

"I think the lesson to be learned is that campaigns to
improve public health run the risk of failing to engage the
socioeconomic groups who stand to benefit most from them,"
Pickett said. "They tend to be embraced more enthusiastically
by better-off families, so that health inequalities increase as
a result."

Pickett and colleagues at the University of Chicago, used
the US Linked Birth/Infant Death Data Sets to look at the
effectiveness of the 'Back to Sleep' drive.

"There was no evidence that inequalities in SIDS were
reduced after the campaign," they report in the American
Journal of Public Health. In fact, the likelihood of SIDS
occurring in lower social classes increased between 1989-1991
and 1996-1998.

A "general conclusion" to be drawn from these data, Pickett
said, is that "if you want to reduce health inequality, the
people most likely to respond to interventions are those who
need them least."

That being so, "Policies that address the root causes of
social inequalities are likely to be far more effective in
reducing a wide range of health inequalities than any number of
public health campaigns targeted at specific risky behaviors,"
she concluded.

SOURCE: American Journal of Public Health, November 2005.