REACH Partners FACED Flint Odyssey House/Health Awareness Center Genesee County Community Action Resource Department Genesee County Health Department U-M SPH/PRC Genesys Regional Medical Center Greater Flint Health Coalition Hurley Medical Center Mott Children’s Health Center PRIDE Priority Children U-M Flint Genesee County REACH 2010 Project 9/08
Our Community Action Plan Derives from two points of view: –Bench –Trench Genesee County REACH 2010 Project 9/08
Bench Racial disparities in infant mortality have persisted despite at least 2 decades of applied contributions from the clinical, scientific laboratory and legislative arenas to reduce racial disparities. –Two explanations: No single intervention is likely to eliminate racial disparities in infant mortality The period of pregnancy is simply too short to effectively address many risk factors important to infant health. Genesee County REACH 2010 Project 9/08
Trench –If you always do what you’ve always done, you’ll always get what you’ve always gotten. If you want something you’ve never had, you have got to do something you’ve never done. Genesee County REACH 2010 Project 9/08
Thinking Outside of the Box A Different Approach to Address Infant Mortality “Trench” Community-based Partners “Bench” Genesee County REACH 2010 Project 9/08
Socio-Ecological Model Genesee County REACH 2010 Project 9/08
Addressing Infant Mortality in Genesee County: Our Model MATERNAL-INFANT HEALTH Fostering Community Mobilization Enhancing the Babycare System Reducing Racism
Community Dialogues Priority setting and problem-solving regarding infant mortality –Two action groups organized –Black Men for Social Change –Women Taking Charge of Their Health Destiny Provide needed assistance to mothers Community empowerment & education Health fairs Genesee County REACH 2010 Project 9/08
Community Media Campaign Radio spotsRadio spots TV commercialTV commercial Posters, fans, T-shirtsPosters, fans, T-shirts Billboards Genesee County REACH 2010 Project 9/08
Provider seminars and community roundtables Perinatal risk assessment tool Perinatal morbidity and mortality reviews Safe sleep campaign PRIDE Medical Services Committee Genesee County REACH 2010 Project 9/08
Maternal/Infant Health Advocates Peer support System navigation Community “windshield” tours Genesee County REACH 2010 Project 9/08
University “Cultural Competence in Health Care” Course Designed and offered at University of Michigan – Flint –Specialized training for client advocates –Enhance culturally competent practice –Improve patient-provider communication –Patients more likely to keep prenatal care appointments Genesee County REACH 2010 Project 9/08
Undoing Racism Workshops –2 ½ day facilitated event –24 workshops with over 880 participants –People’s Institute, New Orleans, Louisiana –Impact Attitudes and beliefs towards culture and racism Diffusion of impact Follow-up working groups of community residents Genesee County REACH 2010 Project 9/08
African Culture Education Development Center History and culture lectures Middle Passage Experience Post-Traumatic Slavery Disorder Curriculum Genesee County REACH 2010 Project 9/08
Annual Infant Mortality Rates by Race Genesee County, MI 1999-2006 Source: Michigan Department of Community Health, Vital Records & Health Data Development Section.
Infant Mortality Disparity Ratio* Genesee County, Michigan 1999-2006 *African American to White Disparity Ratios Source: Michigan Department of Community Health, Vital Records & Health Data Development Section.
3-Year Moving Average Infant Death Rates Genesee County and Michigan 1997-2006
Designed to assess: Process – Documentation of activities Outcomes – Changes in systems and individuals Impact – Changes in African American infant mortality rate and disparities with White infant mortality rate
REACH 2010 Evaluation Racism and Health Disparities Survey Asses experiences of racism, responses to experiences of racism, perceptions of the health care system, relationships with partners, health and birth outcomes. Telephone interviews were conducted by the Michigan Public Health Institute in April and May, 2007 Respondents included REACH Program participants, randomly selected community members aged 18-45 in the REACH focus ZIP Codes in Genesee County, and randomly selected community members aged 18-45 in demographically similar ZIP Codes in neighboring Saginaw County.
Socio-demographic trends American infant mortality rates would be difficult to explain by trends in the teen birth rate, percentage of births to unmarried women, educational attainment, household income, or poverty. No other age group of African Americans (assessed in 5 year age groups) exhibited a decline in mortality rates in 2004 and 2005 as African American infants did.
Conclusion The reduction in infant mortality rates in Genesee County, especially for African American infants, encourages the continuation and replication of activities in Genesee County’s REACH 2010 program. These activities continue as the Genesee County REACH partnership was selected to be a Center of Excellence in the Elimination of Disparities in the CDC’s REACH US program.
Shannon Brownlee, MPH Genesee County Health Department (810) 341-7661 firstname.lastname@example.org@gchd.us Contact Us… Center of Excellence in Eliminating Disparities Daniel Kruger, PhD Prevention Research Center University of Michigan School of Public Health (734) 936-4927 email@example.com www.gchd.us