If your ZIP code is 84111 and you're pregnant, chances are your baby's odds for survival wouldn't be much worse if you moved to a Third World country.
Health officials are concerned about an unusually high infant mortality rate in the section of Salt Lake City that has that ZIP code - an area bordered by South Temple and 1300 South and by State Street and 500 East.Jillian Jacobellis, a bureau director with the Salt Lake City/County Health Department's Family Health Services Division, said she has noticed for a long time that the number of death certificates rival the number of birth certificates in that area.
She's not surprised. "I'm a trained nurse midwife," she said. "I've worked in that area and I know of the need."
According to Salt Lake County Commissioner Mike Stewart, 285 babies died in that ZIP code in 1990.
"That's more than (the total number of people) killed last year by homicide statewide," he said.
While an average of only eight out of 1,000 babies die statewide, the rate is 18.9 per 1,000 in the 84111 ZIP code and only slightly better in surrounding neighborhoods.
That's not far from the rate in some of the nation's worst areas and in Third World countries. The inner part of Chicago, for instance, has an infant death rate of 23 per 1,000, Jacobellis said.
She said the federal government has given a grant of almost $600,000 to Salt Lake City, Salt Lake County and the state for programs to solve the problem. The money arrived in January, and Jacobellis has helped organize what she calls a "one-stop shopping service" for pregnant women in the area.
The service is designed to entice the women, who tend to be poor and uneducated and who generally do not speak English well, to obtain prenatal care. The Health Department will provide immunizations, help with obtaining welfare aid, transportation to other medical centers in the valley and baby-sitting."Transportation and child care are part of the reasons women don't receive proper prenatal care," Jacobellis said.
She also plans to use part of the money to study why women in that part of town aren't receiving the proper care. "We're going to go door to door talking to women," she said, adding she will have bilingual assistants with her when she does so.
Dr. Stephen D. Ratcliffe, director of maternal-infant programs at the five Salt Lake Community Health Centers, said he understands the problem. The five centers, sponsored by the U.S. Public Health Service, also are helping by trying to prevent babies from being born too small.
"By having a very systematic, well-implemented program, we have seen about a 100 percent reduction in low birth-weight from calendar year 1988-1990 in all five centers," he said.
The Central City Community Health Center, 400 South 520 East, is sponsored by Intermountain Health Care. In 1990, that center delivered 93 babies. Only three were low-birthweight - much lower than systemwide rate. However, few of those babies were born to women in the 84111 ZIP code.
"At the Central City office, we service probably no more than 10-12 percent of the pregnant women in the 84111 ZIP code," Ratcliffe said.
Stewart said the grant will help save babies. He asked for volunteers to tend children while needy mothers get care.
"We think that with this prenatal care we can wage this war," he said. "We think we've got the enemy on the run."
Infant mortality rates include all babies who die during the first year of life. Ratcliffe said the deaths can be due to a number of reasons, but the leading one is premature birth. Others are sudden infant death syndrome, accidents and abuse.