Identifying best practices in a successful program to reduce 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 perinatal health outcomes to determine best practices and document successes. This effort includes the Racism and Health Disparities Survey, which has been custom designed to address outcomes specified in the initiative's logic model and the content of intervention programs. Comparisons are made between REACH Participants, non-participant residents of Genesee County, and residents of neighboring Saginaw County in demographically similar ZIP Codes. Analyses investigate the impact of the REACH program on perceptions of racism, experiences of racism, responses to experiences of racism, perceptions of the health care system, perinatal health outcomes, and general health outcomes. Analyses distinguish racism at the individual and social level, and evaluate the effectiveness of different components of the REACH initiative.