TOOLS, PLANS AND PROGRAMS FROM ACROSS NORTH CAROLINA AND THE COUNTRY Resources for Our Work

A society's infant mortality rate is considered an important indicator of its health, because infant mortality is associated with socioeconomic status, access to health care, and the health status of women of childbearing age. (Congressional Budget Office, 1992) Every day, two babies die in North Carolina!

Increased Risk Minority women experience disparities in poor birth outcomes, in health as they age, and a shorter life expectancy compared to Caucasian women.

So, what’s been happening?

National Action Learning Collaboratives AMCHP Perinatal Disparities Action Learning Lab ( )  Lessons Learned from State Teams Infant Mortality & Racism Action Learning Collaborative ( )  Six Communities

Partnership to Eliminate Disparities in Infant Mortality CityMatCH, AMCHP and the National Healthy Start Association have partnered 18-month Action Learning Collaborative.  This work resulted in a report that details the process and experiences of the teams as well as a companion document on community action planning. Special report to the W.K. Kellogg Foundation To read more about their projects and access these reports

Minnesota: Innovative Solutions Started their focus in Eliminating Health Disparities Initiative  Worked with community and tribal leaders  10 of 51 grantees  Doula, home visiting, education, and media awareness  Community Health Worker Program – support & mentoring Media: Save 10 Campaign!  10 ways to have a healthy baby message  Worked with men, women, churches, and communities 38% reduction in disparity rate

Minnesota Plan for the Future… Continuous health care for all women of childbearing age and encourage health care homes Preconception and interconceptional care for all women of childbearing age Culturally appropriate family planning and child spacing efforts Use data carefully to monitor disparities

Wisconsin’s 12-point Plan Based on Life-Course Perspective (12 pt. plan) (Lu, Kotelchuck, Hogan, Jones, Wright, Halfon) Improve Healthcare for African American Women  Provide interconception care to women with prior adverse pregnancy outcomes  Increase access to preconception care  Improve the quality of prenatal care  Expand healthcare access over the Life course

Wisconsin continued… Strengthen African American Families and Communities  Strengthen father involvement in African American families  Enhance service coordination and systems integration  Create reproductive social capital in African American communities  Invest in community building and urban renewal

Wisconsin Address Social and Economic Inequities (reducing stress over the life course)  Close the education gap  Reduce poverty among African American families  Support working mothers and families  Undo racism

Wisconsin Plan Principles Maximize cooperation, coordination and integration of efforts among diverse agencies and stakeholders Creation of new strategies and life course approaches – not business as usual Promote shared learning and mutual respect Recognize the critical voice of African American families and community members Build upon or expand models that work Integrate, support and strengthen existing efforts Build and sustain public and political will for action

Michigan’s Focus Michigan has held a series of stakeholder Summits (2001, 2004, 2008) Incorporated the 12 pt. Life Course plan Focus includes:  Smoking, Unintended pregnancies, Chronic disease management, High risk pregnancy delivery in appropriate facility; Good nutrition; Safe Sleep, etc. Michigan held another Call to Action Summit – October 17 th (Governor provided keynote)

Alameda County, California Developed a diverse community coalition which included business leaders, faith leaders and community members. Studied the impact of Place and Race on health outcomes. Reviewed data about their county and where they were having poor health outcomes as well as where they were providing services.  High service areas also had high poor health outcomes. Signaled a necessity for using resource differently and taking a new approach.

North Carolina Efforts! Healthy Beginnings  12 NC communities NC Healthy Start Programs  Healthy Start Corps & Baby Love Plus  15 communities in our state Local Infant Mortality Coalitions  Forsyth, Pitt, Guilford, Durham, etc. Community Health Ambassador (OMHHD) Pregnancy Medical Home/Care Management

Breastfeeding Promotion SIDS / Safe Sleep Folic Acid / Preconception Health Tobacco Cessation Recurring Preterm Birth Prevention Shaken Baby Prevention Home Visiting  Nurse-Family Partnership, Healthy Families America, Parents As Teachers, Early Head Start Statewide Efforts

North Carolina continues… Healthy Women…Healthy Babies  Preconception Health Campaign and other efforts  A Healthy Baby Begins with You! Community Transformation Grant  Tobacco free living  Active living and healthy eating  High impact evidence-based clinical and other preventive services

Other North Carolina Resources Multiple academic and health care institutions with an interest in health inequities. Strong faith communities and collaboratives focused on improving health. More that we’ve probably missed! If your work is not represented here, please…  Tell others about it during your break out group  Tell us about it on the commitment form  Share links and resources with team so we can forward to others

Resources We are NOT resource poor…other states and our federal partners are willing to share their expertise and tools! National Partnership for Action to End Health Disparities  Ten Regional Health Equity Councils  Toolkit for Community Action  Guide to Health Disparities Resources

Unnatural Causes – DVD series Why Place and Race Matter – Policy Link Frameworks Institute Institute for Dismantling Racism Many, many others! See Resources linked to – click on Health Equity Research (yellow section)

So, What Should We Be Doing Now?