A recent article in the Health Section of the Los Angeles Times offered both good and bad news regarding sudden infant death syndrome (SIDS). The good news is that the number of SIDS deaths decreased by 39_tween 1992 and 1996 (4,900 to 3,000, respectively) as a result of parents following the advice of their pediatrician and placing babies on their back instead of their stomach to sleep. The bad news is that a large part of the US population still has not heard the message or has not taken it to heart.

Although the exact mechanisms behind SIDS are still being studied, researchers have found a number of environmental factors that seem to predispose babies to the disorder. These include maternal smoking, bed sharing, being born to a mother who is less than 20 years old at the time of her first pregnancy, and poor prenatal care. Premature babies, low birth weight babies, and babies who are not breast-fed also are at higher risk for SIDS.

A $25-million multicenter study is currently being conducted in the hopes of better understanding the physiological mechanisms behind SIDS. In the meantime, studies have shown that changing an infant’s sleep position can have a significant impact on infant survival. Despite this fact, 244of infants in this country are still being placed on their stomach to sleep, according to a recent study in the Journal of the American Medical Association. The greatest number of SIDS deaths are occurring among African-American and Native-American infants. According to the National Center for Health Statistics, African-American infants are twice as likely as white infants to die from SIDS, while Native-American infants are three times as likely to succumb to SIDS.

It is no secret that many health-related problems are most prevalent among the economically disadvantaged. In many respects, health care is just like any other business in America–quality is based on what one can afford. Nowhere is this difference more evident than in preventive care, a key component in reducing the number of SIDS deaths.

Information dissemination and compliance are the keys to any successful preventive health care program. In the case of SIDS, RCPs can offer a great service to the economically disadvantaged by assisting with self-help programs and participating in health fairs within low-income communities to raise people’s awareness on how to best care for their infant. This approach has been highly successful in raising awareness on issues such as high blood pressure and breast cancer. In these instances, mobile health care vans have visited lower-income neighborhoods, and health care volunteers have provided blood pressure and cancer screening, and educated community members on how to best prevent these diseases. The same approach could be used with SIDS prevention.

In a country as rich in resources as ours, it is a shame that infants, regardless of race, nationality, or economic background, should die from seemingly preventable causes. Until precious medical information is shared with everyone, the gap between the number of white infants and infants of color dying from SIDS will continue to grow. RCPs are in a unique position to help by picking up the baton and taking the message on how to best prevent SIDS to the streets.

Tony Ramos