In the fall of 2008 at the Alameda County Public Health Department, a group of program managers and staff working with pregnant women and families with young children rallied around the charge that 1 in 3 infants were born in poverty in Alameda County. At this time, Alameda county Public Health Department’s Strategic Plan for Health Equity had been created and our staff were working to make health and social equity central to our work. At this time Bina Shrimali (ACPHD) led this group through a Learning Community. The group began with a review of best practices. Through reviewing articles and model programs, they learned what other communities around the country that were and continue to be challenged with high infant mortality rates were doing. One county that they took note of was Genesee County in Michigan.
Flash forward to today; as you will find in the article below, Genesee County is doing it! “Recently released data showed a significant decrease in Genesee County infant death rates.” Genesee County is an example of those doing the work trying to shift the outcomes of infant mortality.
Genesee County sees significant drop in infant death rates; Health department official credits community collaboration
BY Sarah Schuch
GENESEE COUNTY, MI – Recently released data showed a significant decrease in Genesee County infant death rates.
In fact, Genesee County Health Department officials say it’s the lowest it’s been in 25 years.
The infant death rate (from birth to one year of age) for 2010 in Genesee County was 5.7 per 1,000 births compared to 9.4 deaths in 2009, according to a press release from the Genesee County Health Department.
“I’m extremely pleased,” said Mark Valacak, Genesee County Health Department health officer. “This has been an area where we as a department and we as a community have come together to focus on an issue and had success from coming together.”
Seeing a decrease in infant deaths can be contributed to different community groups coming together to improve mother and infant health, promote healthier lifestyles and routine doctor visits and offer better access to care, Valacak said.
One of the biggest drops came in the number of African American infant deaths in the city of Flint, according to the release. Flint’s average infant death rate was 7.5 per 1,000 live births in 2010 compared to the 18.9 per 1,000 births in 2009 and 12.6 in 2008.
The Genesee County African American infant death rate also dropped drastically from 20.3 per 1,000 births in 2009 to 7.9 in 2010.
The death rate among African American infants, which has historically been two to three times greater than that of white infants, was lower than white infant deaths in Flint for the first time, according to the release.
In the city of Flint the white infant death rate increased in 2010 to 9.5 deaths per 1,000 births compared to 4.7 in 2009. In Genesee County the white infant death rate dropped to 4.8 in 2010 from 5.2 in 2009.
The numbers are positive overall, but a harder look needs to be taken into the data to understand it a little better, Valacak said. The trends will need to be followed over the years to see if they continue.
“We want to look at trends over time and ensure that we are dealing with problems we can identify,” he said.
Programs in place
Infant death rates have been on a downward trend since 2007 and many community collaborations and programs have contributed to the success.
The REACH program was one of the first initiatives in the county, which focused on fostering mobilization, health care improvement and reducing racisms for mothers.
The program is funded through federal grand dollars and begin in planning stages more than 10 years ago, Valacak said.
The program puts an emphasis on where racism may play a role in disparity in the community, he said, since typically the infant death rate is much higher than white infant death rate.
To help combat that, University of Michigan-Flint incorporated a cultural competency course to the health sciences curriculum and bus tours were given to medical residents and doctors in the community, Valacak said.
“It helps them recognize that these social determinants play an impact on health and health outcomes,” he said. “(The bus tours are) so they could go into the communities of where some of these patients live so they can better understand where they are coming from.”
Some have poor transportation or lack of access to nutritional foods, he said.
The tour and extra education helps health professionals become more sensitive in the way they do business, Valacak said.
Implementation on things such as enhancing the baby care system and community immobilization and education on topics like proper nutrition, prenatal vitamins, doctor visits, immunizations, breast feeding and the dangers of smoking have also been focus points over the years.
Collaboration with all three local hospitals – Genesys Regional Medical Center, Hurley Medical Center and McLaren-Flint – and partnerships with programs like Healthy Start and Mihas at Your Center also prepare mothers for the arrival of their new babies.
The two programs, as well as the health department’s Back to Sleep initiative, send professionals out to mothers’ homes to make sure everything is safe for the baby’s arrival and to answer any questions they may have.
Continuing the downward trend
One of the most preventative causes of infant death is poor sleep conditions, Valacak said.
From 2000 to 2009 There were 108 infants who died in their sleep; 65 were sleeping with another person; 78 were on a non-infant sleeping surface, such as a couch, bed or inflatable bed; 47 were sleeping face down; eight were sleeping on their sides and six were found wedged between a sleeping surface and something else, such as a wall, said Marcia Franks, Genesee County Health Department public health supervisor for maternal and infant health programs, in a March Flint Journal article.
A proper sleeping environment includes a crib or a pack and play with no pillow or anything else to make is softer. Infants should always be placed on their backs, she said in March.
Valacak believes that education on important matters has made a difference in the infant death rate in the county.
The difficult part, however, is finding ways to see a continued drop in infant death rates, Valacak said.
Earlier this year, the county and Hurley formed a partnership to allow mothers to sign up for Women, Infants and Children (WIC) Supplemental Nutritional Education Program before even leaving the hospital.
And just recently received a grant – $485,000 each year for three years – for a Nurse/Family Partnership Program was given to the health department for nurses to visit the homes of first time mothers, with a focus on African American women.
“It’s like having a nurse be there to tutor you on that book (What to Expect When You’re Expecting) and be there to answer all your questions, help you with any problems, help you maneuver the system and help you get through your first pregnancy,” Valacak said. “We’re hoping this will help us continue this downward trend.”