There are a number of striking features of the American healthcare system compared with those of other developed countries: the huge percentage of our GDP that goes to health (currently at 17.5%); the enormous gap between our spending and health outcomes (i.e., the apparent lack of value); and the tremendous health disparities in this country compared with others. We have recognized these disparities as a particular problem in Milwaukee, and one of our strategic priorities is to address those disparities in our community.
One area we are addressing is safe sleep. In Wisconsin, an average of one baby dies each week in an unsafe sleep environment, and while these tragic deaths are spread across the state, they disproportionately affect the underserved. Children’s Health Alliance of Wisconsin has a safe sleep program that includes a variety of media, hospital, and community-based educational efforts. The ABCs recommendations for safe sleep from the American Academy of Pediatrics include:
- Sleeping alone
- Sleeping on the back
- Sleeping in a crib
- Non-smoking environment
For disadvantaged families, availability of cribs can be a barrier. So one intriguing element of the CHAW program is the Newborn Nest. It is essentially a cardboard box for the baby to sleep in. For real.
Now, lest you think the idea of a baby in a box is crazy, it’s actually based on an extremely successful program from Finland. Basically, all new mothers in Finland receive a maternity package. Unlike in the US, where kits may be given out by hospitals but vary widely, it’s the same for all Finnish moms. The kit comes in a box and includes breast feeding information, along with bodysuits, a sleeping bag, outdoor gear, diapers, bathing products for the baby, as well as bedding and a small mattress – the mattress is designed to go into the box, which serves as a crib! And the culture is such that everyone uses it. Mothers have a choice between the kit and a 140 euro cash grant; 95% choose the kit.
This baby box therefore not only provides a safe sleep environment, it levels the playing field. Imagine how things might be different if all babies in the Milwaukee area, whether they live in Lindsay Heights or Whitefish Bay, napped in the same type of box. Of course, that would require a cultural change that could be even harder to achieve than income redistribution. The Finns note that part of the appeal of the maternity kit is the fact that it symbolizes equality. But when it comes to children, there is a strain of American culture that supports that: for example, the traditional commitment to universal public education dating back to the first years of the Republic.
Our health disparities are a daunting problem. Could the answer lie in a box?