Promising Programs in Racial and Ethnic Disparities in Health and Health Care Addressing...

Infant Mortality

researched and compiled by Sarah McCloskey, Erin Kennedy, and Michele Sloan December 2004 and updated November 2007

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Background
For the years 2001-2003, Delaware’s infant-mortality rate was 9.5 deaths per 1,000 births. The rate for African Americans was 16 per 1,000, compared to 7.5 per 1,000 for whites in the same year. Nationally, the rate was 6.8 deaths for every 1,000 births.* Today, the U.S. is ranked 179th out of 221 countries in terms of infant-mortality rates. Nationally, the infant-mortality rate per 1,000 is 13.5 among African Americans and 9.3 for Native Americans, compared to 5.7 Promising Programs to Eliminate Racial and Ethnic Health Disparities 19 for non-Hispanic whites. Conditions contributing to an infant’s well-being include prenatal care, maternal health, access to health care and socioeconomic conditions. Furthermore, the leading cause of infant mortality is Sudden Infant Death Syndrome (SIDS). Deaths from SIDS are 2-3 times higher for African Americans and Native Americans than for whites.

*Data provided by the Kaiser Family Foundation State Health Facts Online. www.statehealthfacts.org

State Programs
Current state programs focus on behaviors that affect infant health. These include distributing information and encouraging healthy behaviors among mothers. Of particular emphasis are prenatal care, smoking, substance abuse, and nutrition.

California

Fetal and Infant Mortality Review (FIMR) Program of Alameda County – Areas of the county with high infant-mortality rates were found to have high incidence of high-risk behaviors such as prone sleeping, not using cribs, cosleeping, and maternal smoking and substance abuse. Information about SIDS and infant mortality was reworked so that it is consistent throughout the community and is available in the eight major languages spoken in the county. www.acog.org/from_home/departments/NFIMRHomeInterviewers02.pdf For the Alameda County Healthy Start Update Report, visit www.mchlibrary.info/MCHBfinalreports/docs/6H49MC00130.pdf

Seven Principles Project – Created by the San Francisco Department of Public Health to address high infant-mortality rates for African Americans, the program provides social support and education to men and women of reproductive age. It includes a community-awareness campaign to educate healthcare providers and improve cultural awareness. This is an APHA Statistics to Solutions program example. For more information, contact Virginia Smyly at 415-581-2400.

Black Infant Health Program in Los Angeles – This program provides services to pregnant and parenting African-American women ages 18 and older who are at high risk of low-birth rates. These services include health education, doctor referrals, self-esteem classes, and networking with community outreach services. After a formative and summative evaluation of the program, it was shown to heighten community awareness, increase self-esteem, and reduce the rate of infant mortality. ASTHO/NACCHO program: www.lapublichealth.org/mch/BIH/bih.htm

Florida

Northeast Florida Healthy Start – The Magnolia Project – The federal Healthy Start initiative addresses infant mortality through increasing awareness of risks, and improving maternal and infant health. In Northeast Florida, Healthy Start aims to assess the health of clients and increase awareness of available prenatal/infant-care services. Healthy Start provides risk screenings for women/infants and prenatal/infant care, paying special attention to the needs of at-risk clients. Another project, the Infant Mortality Work Group, identifies risk factors leading to high rates of infant mortality among African Americans in Duval County. The results of this study led to the creation of the Magnolia Project, which targets preconception and prenatal care for African Americans to reduce risk factors leading to infant deaths. www.healthystartflorida.com/directory/coalition.asp?CoalitionID=HSNEF

Missouri

Nurses for Newborns Foundation, St. Louis – This project was implemented in all hospitals with neonatal units in Missouri and Tennessee, to help reduce infant mortality rates, specifically among black infants. The program provides home visits to families with limited access to health care from experienced RNs at no charge. The nurses provide intensive parent education, access to community resources, safe-home assessment, medical assessments, diapers, formula, and 24-hour on-call availability for a two-year period. Source: APHA. www.nfnf.org

Nebraska

Omaha Healthy Start – Funded by the U.S. Health Start Program, Omaha Healthy Start has made one of their key focuses is to eliminate racial health disparities in status and health care accessibility to pregnant women and infants. One way in which they promote this is through their program, “Diaper and Formula Pantry” which provides emergency supplies to mothers through local churches in undeserving and minority communities. This has been seen as a successful outreach to the most vulnerable population. www.omahahealthystart.org

New Hampshire

Healthy Families: Minority Health Coalition, Bright Start Home Visiting Program – The Healthy Families program targets pregnant women and teens, educating them about the prenatal period and providing follow-up programs after the baby is born. These educational sessions are held in the participants’ homes so they feel comfortable and supported. Culturally sensitive and nativelanguage- speaking nurses provide bimonthly visits during the prenatal period. Participants are also provided handouts with information on each stage of their baby’s development. www.nhhealthequity.org/english/pro_healthfam.cfm

North Carolina

First Step Campaign: Minority Infant Mortality Reduction (MIMR) –This campaign, created by the non-profit organization North Carolina Healthy Start, is designed to help men and women access health care and educate them on living with good habits and on proper infant care. MIMR specifically focuses on individual health education and community education by distributing free materials and providing a bilingual toll free telephone service with professionals available to provide necessary information to mothers and fathers. www.nchealthystart.org/firststep/mimr.htm

Ana Maria Latino Outreach Campaign – Another campaign created by the North Carolina Healthy Start Foundation, the Ana Maria Campaign is North Carolina’s first public education campaign solely targeting Hispanics. Using linguistically appropriate materials, this outreach initiative attempts to raise awareness of the infant mortality issue and educate families on how to access care and maintain a healthy lifestyle. They also have a bilingual, toll free help line available for Hispanic parents. www.nchealthystart.org/latino

South Carolina

Black Infants Better Survival Program (SCBIBS)– SCBIBS is a collaborative of the South Carolina department of Health. This program is dedicated to reducing the infant mortality rate among African Americans by helping parent’s access better information and resources to ensure better health and well being for their children and families. This program also provides a care line so that families can access heath care related information more readily and receive assistance and support to the mother to be. www.scdhec.gov/health/mch/scbibs

For more information, contact Eric Jacobson (302-831-1711).

photo on this page courtesy of the Administration on Aging

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