Infant mortality has long been considered one of the biggest public health concerns in Indiana — and for good reason.

Indiana's infant mortality rate is consistently worse than the national average. In fact, Indiana's rate in 2013 was 7.4 deaths per 1,000 live births, according to the Kaiser Family Foundation. The U.S. average was 6.4.

According to the World Bank, the United States ranks 46th, right between Serbia and the Slovak Republic.

At least 1,079 children in Northwest Indiana never celebrated their first birthdays, according to 12 years of federal child mortality data analyzed by The Times late last year.

A Times computer-assisted review of federal cause-of-death data for youth in Lake, Porter and LaPorte counties revealed that collective causes of infant mortality ranked as the single largest category of child death between 1999 and 2010.

Awareness of this issue has been building in Indiana, which should be taken as a sign of hope for improvement.

When Gov. Mike Pence took office in January 2013, he instructed the Indiana State Department of Health to make lowering this rate a top priority.

An Indiana report on infant mortality released this year shows four of the top 10 zip codes with the most infant deaths are in Gary. 

In March, Indiana's health commissioner, Dr. Jerome Adams, told One Region's Northwest Indiana Health Advisory Council the causes of infant mortality differ across the state. 

Smoking during pregnancy, one of the risk factors for infant mortality, is significantly less prevalent in Lake County than elsewhere in the state. But focusing on breastfeeding might help. African-American mothers tend to breastfeed less than white mothers.

Denise Dillard, chief consultant for government and external affairs at Methodist Hospitals, offered another potential local approach. "We need to give them portable cribs — that's where the need is," she said. Portable cribs would be good for infants whose mothers live on the couches of friends and family members.

Sleep habits are a major factor in infant mortality.

A program in Marion County should be considered in Northwest Indiana as well. That initiative sends registered nurses into the homes of low-income, first-time mothers.

The program is funded through a series of grants. Since 2011, it has served more than 1,100 first-time mothers. The nurses teach the moms about healthy lifestyle choices during pregnancy, the benefits of breastfeeding and of positive interaction with their babies.

Indiana's new state budget includes $11 million for grants under the Safety PIN (Protecting Indiana's Newborns) program in the 2016 and 2017 fiscal years. The grants are for local programs where women receive prenatal care, learn about safe sleep practices for infants, and learn the benefits of breastfeeding. The grants also will cover programs to help expectant mothers quit using drugs, alcohol and tobacco.

Another $2.5 million is devoted to development of a website to reach at-risk mothers.

At Mother's Day, we are especially mindful of issues like this. But this top public health issue deserves attention all year. Progress must be made to protect Indiana's infants.

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