Best practices and policy changes in reducing disparities in infant mortality

The Genesee County REACH 2010 initiative focuses on reducing disparities in perinatal health and infant mortality in Genesee County, MI. Partners in this initiative agree that no single intervention will eliminate racial disparities and that interventions must precede, include, and follow the period of pregnancy. Core themes for the work include: reducing racism, enhancing the medical care and social services systems, and fostering community mobilization. Strategies include community dialogue and awareness, education and training, outreach and advocacy, and mentoring and support. Vital statistics data indicates a substantial drop in African American infant mortality in Genesee County in 2005. The African American infant mortality rate remains lower in 2006 than in years prior to intervention activities. The REACH initiative is conducting an in depth investigation of intervention activities and policy changes to document successes in improving perinatal health outcomes. This analysis will coordinate vital statistics data with the operation of program initiatives and health system policy changes resulting from the initiative. Indicators, tracked on a monthly basis, include: average month of pregnancy when prenatal care began, average number of prenatal care visits, average weeks of gestation and proportion of premature births, average birth weight and proportion low birth-weight, 1 minute and 5 minute APGAR scores, tobacco and alcohol use during pregnancy, maternal weight gain, Kessner index scores, Kotel-Chuck index scores, number of medical risks presented, and number of pregnancy complications. Vital statistics data will be coordinated with to assess the impact of individual intervention components.