HEALTH OFFICIAL CITES BEHAVIORAL CHANGES AS KEY TO RAISING LOW BIRTH WEIGHTS

WASHINGTON -- The problem of low birth weight is growing in America's largest cities and suburbs, according to a new study, but a health official from the city with the smallest ratio of low birth weights stressed this week that lifestyle changes - particularly smoking cessation - have made a difference there.

Lillian Shirley, director of the Multnomah County Health Department in Portland, Ore., pointed to smoking as the culprit for 30 percent of babies born below the optimal birth weight, and added that a community approach to fighting smoking and secondhand smoke has helped Portland. She said that community involvement is a core element to health goals her city has met.

"The public health picture isn't a still-life, it's dynamic. … This achievement reflects the lifestyle of our entire community," Shirley said. "Promoting exercise, healthy diet in the community - these efforts can make a difference."

Portland's data was included in a report on seven of the goals outlined in the federal government's Healthy People reports. In 1999, 5.4 percent of Portland's babies were born below optimal birth weight - a percentage that exceeded the goal of 5 percent or less. The report examined the rate of low birth rates, as well as other diseases and conditions, in the nation's 100 largest cities and their suburbs. As of 1999, none of the cities studied - and only two of the suburban areas - had met that goal. That compares to 1990, when 14 of the tallied suburbs had met the 2000 goal.

"While cities [compared to suburbs] still have high low birth weights, the gap is narrowing," said Dennis P. Andrulis, one of the authors of "Healthy Cities, Healthy Suburbs," the first of four studies from Brooklyn's SUNY Downstate Medical Center to examine health issues among urban and suburban communities. "There are troubling new patterns around low birth weight. Many suburbs lost ground."

Andrulis added that the rising rates of low birth rates "serve as a not-so-early warning sign about the health of our next generation," and noted that the health care system should prepare for implications of low birth weights in the near and distant future. He expressed particular alarm that low birth weight rates in suburban areas now exceed the rates in the cities.

"We didn't expect the suburbs to now be leading the cities," Andrulis said. "[Low birth weight] had been such a classic inner-city problem."

In contrast to Portland and suburban Stockton, Calif., where only 4.5 percent of babies were born below desired weight, Baltimore had the highest percentage of 1999's low birth-weight babies (14.7 percent). Suburban Lubbock, Texas, registered the highest incidence of low birth rates for suburban areas, with a rate of 9.6 percent.

Dr. Michael McGinnis, senior vice president and director of the Health Group at the Robert Wood Johnson Foundation, which funded the study, underscored how the nation's health infrastructure deserves much of the credit for the report's good news, like lowering syphilis rates 86 percent during the 1990s.

The good news in syphilis, said McGinnis, seems to be less related to responsible sexual behavior than to health departments' expertise at identifying and tracking cases of the sexually transmitted disease.

In this first study, which looks at low birth weight, infant mortality, tuberculosis, AIDS, syphilis, gonorrhea and homicide, researchers examined data from the U.S. Census, the FBI, and the Centers for Disease Control and Prevention.

In coming months, other studies from SUNY will examine suburban-urban differences and similarities with regard to health and diversity, children's health and welfare and population growth.

Health Behavior News Service: (202) 387-2829 or www.hbns.org.