Healthy Families Equals Healthy Babies
By Stacey D. Cunningham, MSW, MPH
Executive Director, National Healthy Start Association
Annually, those of us in the world of public health and maternal and child health designate September as the month to focus on efforts that will increase the public’s awareness of infant mortality. From family festivals in the park to lectures on health and racial inequities, many of us will be engaging communities around the issues and factors that impact infant mortality. It is no secret that the health of our families is essential to the health of our country. That is why, this year the National Healthy Start Association developed the theme Healthy Families = Healthy Babies for National Infant Mortality Awareness Month. We know that when our families are healthy, so are we. It has been noted that the health of a nation can be determined by its infant mortality rate (IMR), the annual rate at which infants under one year of age die. So what does our country’s IMR tell us about the health of its population? According to the National Vital Statistics Report, in 2006, the infant mortality rate was 6.69 infant deaths per 1,000 live births.[i] This is a 2 percent decline since 2004 when the United States ranked 29th in the world in infant mortality and the rate was 6.78 infant deaths per 1,000 live births.[ii] While the United States has made some improvements in infant mortality, disparities among Black and White infants continue to exist. African Americans have 2.3 times the infant mortality rate as non-Hispanic whites. In addition, Hispanic and American Indian communities are dying at rates that are three to four times higher than White communities. Many minority communities also have infant mortality rates that are three times higher than the national rate. To further compound these rates, babies in minority communities are four times as likely to die as infants due to complications related to low birthweight as compared to non-Hispanic white infants.[iii] So we must ask ourselves how healthy are our minority communities? How are our African American, Hispanic and American Indian families faring? These are questions that many MCH professionals may ask themselves regularly as they work endlessly to improve the health of our most vulnerable families.
Addressing the health of families, means addressing the issue of infant mortality, especially in minority communities. In 1991, 15 Healthy Start Projects in rural and urban areas were established in a demonstration phase to do exactly this — create community-based maternal and child health programs to reduce infant mortality in communities with infant mortality rates 1.5 to 2.5 times the national average and address significant disparities in perinatal health.[iv] The communities with high infant mortality rates consisted primarily of minority families. Since then, the projects have grown to 102 sites in 38 states, the District of Columbia, and Puerto Rico, striving to improve the health of infants and families in all minority populations — Hispanics, American Indians, African Americans, Asian/Pacific Islanders and immigrants. Improving pregnancy and birth outcomes are achieved through core services of direct outreach, case management, healthy education, interconceptional care and screening for depression. Families are kept at the forefront of service delivery through a consortium composed of the clients/consumers, neighborhood residents, mental health and social service providers, and faith and business community representatives. Collectively, the consortium, the Healthy Start Project site and the community work together to address barriers to care and improve the local system of care for women and children.
Healthy Start projects are situated in the poorest of neighborhoods and residential areas in the United States. Their commitment to providing services that address the “whole family” speaks to their uniqueness and their success in sustaining programs that utilize evidence based practices and innovative community-driven interventions. They are responding to the health care needs of our most vulnerable families to ensure women are healthy, babies are born healthy and families are healthy. They are helping to shape and improve the health of our nation. So as we focus our attention this September on how we can increase awareness and educate communities about infant mortality, let us remember to include the whole family in the programs, services and resources we are delivering to neighborhoods that will help them to achieve optimal health.
[i] Heron MP, Hoyert DL, Murphy SL, Xu JQ, Kochanek KD, Tejada-Vera B. Deaths: Final data for 2006. National vital statistics reports; vol 57 no 14. Hyattsville, MD: National Center for Health Statistics. 2009.
[ii] MacDorman MF, Mathews TJ. Recent Trends in Infant Mortality in the United States. NCHS data brief, no 9. Hyattsville, MD: National Center for Health Statistics. 2008.
[iv] Giffin MF, Curry BS, Sullivan J. 1999. Telling the Healthy Start Story: A Report on the Impact of the 22 Demonstration Projects. Arlington, VA: National Center for Education in Maternal and Child Health.