November 17, 2005

Social Inequality Seen in SIDS Risk

By Megan Rauscher

NEW YORK -- 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.