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This is a re-run from 2013 and, probably, one of the coolest innovations in public health out there, and something we probably should be considering more widely. -- Dan

Children of the Box

In the mid-1930s, infant death rates in Finland were a very high 65 out of 1,000 live births. Social scientists attributed many of these deaths to two factors. First, expectant parents sought too little prenatal care (often because they were too poor to afford it). Second, these parents brought the baby home into a house with inadequate, well, stuff — too few diapers, not enough baby clothes, and often, nowhere for the baby to sleep. And as any parent of a newborn will tell you, the worst time to figure out what you need for a baby is when you first come home and realize, holy cow, you have a baby.

So Finland came up with an idea: a gift box, delivered before you deliver. It originally contained fabric so expectant mothers could create clothes for their newborns, as well as many of the items that are still in the box today. Over the years, the new baby box has grown into a robust cornucopia of tiny awesomeness. There's a little mattress and concordant bedding; a snowsuit set with mittens, a hat, and booties; bodysuits, socks, and other everyday-wear; some bathroom items, such as a towel and toothbrush; and even bra pads and condoms. (Here's a full list, with pictures.)

The box truly aimed to deliver all the stuff you'll need to for your little one (and some other stuff). All the would-be mother needed to do is seek out a doctor for a checkup or five while pregnant. The gift box program, which was originally provided only to low-income families, soon became very popular, and now is a staple of Finnish culture. All expectant mothers who seek prenatal care are offered the box. Almost all of them — 95% — take it. The remaining 5% take a small cash amount instead, but the sum total of the items included in the box are easily worth more than the amount offered.

But the most distinctive part of the gift box offering — and the items which best defines the Finnish newborn culture — is the box itself. Because many of the poorest households couldn't afford cribs, the boxes were specifically designed to act as cots, as seen below.

Now, according to the BBC, a majority of Finns grow up — for a few weeks or months, at least — sleeping in a box. (The lid isn't on, don't worry!) Oh, and one other thing: the box helped solve the problem. Infant mortality in Finland fell from a peak nearing 90 per 1,000 in the 1940s to the single digits by the late 1970s. Finland now has one of the lowest infant mortality rates in the world.

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Bonus fact: During the 2010 Winter Olympics in Vancouver, the British Columbia Centre for Disease Control distributed condoms to athletes, support staff, and volunteers at the Games. During the 17 days of the Olympics, a total of 100,000 condoms were distributed through the program — and they ran out, requiring what some media termed an "emergency" delivery of prophylactics. Assuming four staff/volunteers per athlete, that's about three condoms per person. But most likely, they weren't all (or even mostly) used during the two-plus weeks of athletic competition. One public health official told CNN that "[heard] stories of athletes from countries with inferior condoms stuffing their suitcases with the coveted rubbers."

From the Archives: Life in the Fast Lane: How Finland combats speeding.

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