Partnership to Eliminate Disparities in Infant Mortality
In 2008, CityMatCH, the Association of Maternal and Child Health Programs (AMCHP), and the National Healthy Start Association (NHSA), with funding from the W.K. Kellogg Foundation*, created the Partnership to Eliminate Disparities in Infant Mortality, with an aim to decrease racial disparities in infant mortality in U.S. urban areas. The Infant Mortality and Racism ALC is the first project of the Partnership.
Why this Work is Important
“Racial and ethnic disparities in health care occur in the context of broader historic and contemporary social and economic inequality,” declared the Institute of Medicine (IOM) in its landmark report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. With this, the IOM has created an opportunity to broaden the conversation and scope of action from “embracing diversity” and “promoting cultural competence” to what lies beneath: racism and inequality.
The health issues impacted by racism are broad. In order to focus the work, this Action Learning Collaborative (ALC) addresses one critical area – infant mortality. Lu and Halfon in their 2003 article, Racial and Ethnic Disparities in Birth Outcomes: A Life-Course Perspective, state that, “One of the most persisting health disparities is that of birth outcomes between African Americans and White Americans. An African American infant born today is still more than twice as likely to die within the 1st year of life as a White infant.” Additionally, they contend that, “… risk factors [e.g., socio-economic status, behaviors, prenatal care, stress, and infections] differ between Black and White women, resulting in differential impact on their reproductive health” and “…while race as a biological concept may have little scientific meaning, as a social construct it may have profound health consequences.”
The Action Learning Collaborative (ALC)
CityMatCH, AMCHP and NHSA acknowledge that no one organization or membership can realize measurable success in promoting health equity alone, which is why we launched this ALC, focused on infant mortality and racism. ALC’s are intensive training programs that bring diverse state, local and community agencies and programs together to tackle priority issues, promote collaboration and improve programs, policies, and public health systems. This ALC addressed the need for maternal and child health leaders to: learn what has worked across the country from both their peers and subject matter experts; discuss how to tailor interventions for community, local and state practice; and, become part of a larger learning community linked to other efforts to undo racism and eliminate health disparities.
Selected Strategies of the ALC Teams
Aurora, CO – Complete PPOR data analysis process to provide primary prevention direction for deaths occurring in the group that appears to have the highest indicator contributing to the infant mortality rate.
Chicago, IL – Increase awareness of the impact of racial and social inequities on health outcomes, specifically MCH by showing Unnatural Causes…..is inequality making us sick?
Columbus, OH – Develop / adapt tools to learn from health care consumers their experiences of racism in health care settings and incorporate findings into a training tool kit; Develop and pilot a training tool kit for health care providers to understand and identify the effects of racism on Infant Mortality; Participate on the Ohio Infant Mortality Task Force in order to advocate for addressing racism and its effects on Infant Mortality.
Los Angeles, CA – Develop a quarterly electronic newsletter (E-letter) describing and addressing racism and its relationships to birth outcomes in Los Angeles County; Identify and distribute existing educational materials (videos, Power Points, articles, etc.) that relate to infant mortality and racism. Hold trainings and discussion groups for providers and the community in SPA 1 and 6. Target audience will include various ethnic groups; Design LAC-ALC website which will serve as a one point information center for LAC residents to inquire resources and best practices relating to infant mortality and undoing racism.
Milwaukee, WI – Ensure that the Milwaukee PEDIM Model, both the core group and the larger group, have opportunities for new learning collaboration, partnerships, active learning and decision making related to the three (3) program specific strategies which have been identified; Develop a community education plan designed to inform the larger Milwaukee community regarding the role that racism plays in infant mortality rates, especially as it affects African American males; Develop a media campaign designed to promote the positive roles of African American males and Milwaukee’s infant mortality rates; Establish an “Empowerment Coaching” pilot of 50 African American males (teens and adults) who want to support their pregnant wives and or significant other or their infants, but do not have the knowledge, skills or resources.
Pinellas County, FL – Connect and integrate ALC work into other community initiatives; Facilitate an update of PPOR data for the next three year cycle (2004-2006); Disseminate acquired information and educate community stakeholders; Develop the ‘business case’ for why this work is critical.