The Infant Mortality Awareness Campaign informs the Washington, DC community about the number of babies who die within the first year of life in our nation’s capital. Through shocking photographic images placed on city buses, the campaign personalizes the fact that the Infant Mortality Rate in the District of Columbia is twice the national average. One of every 67 babies dies in the District. Every 59 hours, a baby dies in the District.

There are many causes of infant mortality: low birth weight, congenital anomalies, Sudden Infant Death Syndrome (SIDS), abuse and neglect, and untreated or untreatable illnesses. Most babies who die before their first birthday die within the first month of life. Some of these deaths can be prevented with adequate preconceptional care and prenatal care.

Community Healthy Start began to develop our public health Infant Mortality Awareness Ad Campaign in the spring of 2001. We conducted focus groups with women and men. In the groups, we presented the most recent data about infant mortality in the District. The District’s high infant mortality rate upset the focus group participants. Their reaction to the data was telling. They questioned the source of the information and asked why, if this was such a widespread problem, why were they unaware of it? We interpreted their reactions to indicate that the reality of infant mortality in the District was emotionally overwhelming.

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(The third of 3 ads that appeared on the outside of DC Metro Buses.)

As a result, our first thoughts were to display photographs of beautiful, healthy, babies in order to make the issue more approachable. We were close to taking photographs of babies playing in fields of flowers, when Jacob Tom, an art director with many years of advertising experience, studied the results of the focus groups, reviewed the Healthy Start mission, and consulted with a group of his peers. Mr. Tom convinced us that a shocking, but realistic, view of infant mortality would force people to confront the issue.

Our ads inform viewers with the startling statistics about the infant mortality rate and provide provocative images to personalize the numbers. The images capture the heartbreaking tasks that accompany the death of an infant: the shrouded lifeless body lying on cold steel in a morgue, the child’s casket being carried during a funeral service, and the hearse traveling to the cemetery.

We want people from all walks of life to talk about infant mortality and feel outraged at the monumental and unacknowledged tragedy taking place in our community. We want everyone to appreciate that there are no excuses for the fact that a baby dies every 59 hours in the capital of the wealthiest nation in the world.

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(The first of 3 ads that appeared on the outside of DC Metro Buses.)

Our hope is that if people talk about infant mortality, then they will inquire about what can be done to prevent these tragedies. We encourage our sister, daughter, granddaughter, neighbor, wife, and girlfriend, to get early and consistent prenatal care. We help her get to her appointments and talk to her about the risks of smoking, drinking, and using drugs. We encourage her to take care of herself first. Finally, we talk to the women and men in our community about preparing our bodies for pregnancy to help them understand that the foundation to a healthy pregnancy can begin before conception.

The Public Service Announcements ads appear on Washington Metropolitan Transit Authority buses. The ads run for consecutive months, beginning in March, and continuing through mid summer, with a different ad displayed each month.

There are two types of bus ads: those appearing in the interior and those on the exterior. Both types of ads appeared in English or Spanish. The interior ad displays the toe tag image while the exterior ads display either the toe tag, the child's casket, or the hearse image. Both types of ads include a phone number (202 - 321-PREG) connecting the caller to Community Healthy Start services in order to receive referrals for prenatal care, food, clothing, shelter, and other area resources.

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(The second of 3 ads that appeared on the outside of DC Metro Buses.)

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The interior bus ads circulating throughout the city.

The interior bus cards provide more information about what Healthy Start offers such as health education and support, referrals for entitlements, counseling, advice from a nurse, and home visits. The interior ads state that all our services are free. Although meant to provide the public with data about the incidence of infant mortality, these ads target pregnant women who need services.

The exterior bus cards provide statistics about infant mortality and ask the reader "Pregnant and Need Advice? Call 202/ 321 PREG." The exterior ads educate the public about the incidence of infant mortality.

Pregnant women, their friends, and relatives, make up the overwhelming majority of our callers. An alarming number of the callers are in their third trimester of pregnancy and have received no prenatal care. Some of the pregnant women are being abused, others need food and others need places to live. In all these cases, we provide assistance, and link the person with ongoing services such as Healthy Start. Though we anticipated receiving calls from persons who were offended by the ads, we received just one call from a woman who told the story of how her baby died and stated, "I was on the bus when I saw your ad and didn’t want to cry in front of everyone." We explained our purpose, and she told us she understood.

If you have questions about the campaign, you may call (202) 321.PREG, or Katy Gingles, Program Director of Community Healthy Start, Mary's Center, at 202. 483. 8319, extension 357, or Lola Pol, Program Administrative Assistant, at 202. 483. 8319, extension 358. We look forward to your questions, comments, and concerns.

Paid for through private donations to Community Healthy Start, Mary's Center for Maternal & Child Care, Inc.; the Healthy Start Initiative, Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services; and through the generous support of Jacob Tom, Art Director; Scott Maney, Copy Writer; and Harry De Zitter, Photographer.

[1] Infant mortality data for the District used in the ads from the National Center for Health Statistics at the Center for Disease Control, the Briefing Paper on the 2000 Infant Mortality Rate for the District of Columbia prepared by the State Center for Health Statistics Administration, Department of Health, and the National Institute of Child Health and Human Development. The statements that appear on the ads are based on infant mortality data spanning 10 years, from 1990 to 2000 (the last year for which District data is available as of March, 2003.)

[1] Paid for through private donations to Community Healthy Start, Mary's Center for Maternal and Child Care, Inc., the Healthy Start Initiative, Maternal and Child Health Bureau, Health Resources Services Administration, US Department of Health and Human Services, and through the generous support of Jacob Tom, Art Director; Scott Maney, Copy Writer; and Harry De Zitter, Photographer.