Promoting Health Equity in the National Strategy on Infant Mortality

OVERALL6.9 NONHISPANIC WHITE5.8 HISPANIC 5.6 ASIAN/PACIFIC ISLANDER 4.9 NATIVE AMERICAN8.1 NONHISPANIC BLACK13.6 Mathews & MacDorman, 2008

“Infant mortality is the most sensitive index we possess of social welfare “Infant mortality is the most sensitive index we possess of social welfare...” - Newsholme, 1910

The U.S. ranks behind 24 other countries in infant death

“Our destiny is sharedThis country only works when we accept certain obligations toward one another and toward future generations. ” “Our destiny is shared. This country only works when we accept certain obligations toward one another and toward future generations.” - President Barack Obama, 2012

Persistent disparities in health… …a “biologic expression” of persistent social inequalities

Reduce racial/ethnic and income disparities, influence social determinants, and increase health equity through investments in higher risk communities and programs to reduce poverty and racism

Eliminating Health Disparities in Infant Mortality Called for a strategic action plan that: – Recognized bio-psycho-social determinants – Examined disparities in the “sociological context of race” – Understood lifelong accumulation of risk due to poverty and racism – Recognized the need for major investments in place- based, community-driven, multi-sector initiatives such as Healthy Start model

“A national strategy to reduce infant mortality must include sustained commitment to address social determinants of health in order to increase health equity.”

Convene an interagency expert panel to set goals for closing infant mortality gaps Support and transform Healthy Start and maximize its potential to reduce infant mortality, eliminate disparities, and increase health equity Use federal interagency collaboration to address social determinants of health by concentrating investments in place- based initiatives with Healthy Start sites as the hub Address and alleviate poverty through enhanced use of income supports Add SACIM to list of HHS Initiatives aiming to eliminate disparities and increase health equity

HHS Action Plan to Reduce Racial and Ethnic Health Disparities – More accessible, equitable health care – More informed, diverse, culturally appropriate health workforce – Improved availability and effectiveness of community-based programs – Improved availability and quality of data – Greater collaboration and accountability across HHS Affordable Care Act – Broaden access to care – Invest in prevention – Improve data collection and monitoring

Health equity: a BIG IDEA that’s an OLD IDEA

“We are an American family and we rise and fall together... Forward – that’s where we need to go ” “We are an American family and we rise and fall together... Forward – that’s where we need to go” - President Barack Obama, 2012