Eliminating disparities in infant mortality: What models work?

Problem: Infant mortality is a key predictor of the population's health. According to the National Center for Health Statistics, the death rate for black infants is 14.1 deaths/1,000 live births totaling more than twice that of the national average of 6.9 deaths/1,000 live births.

Methods: In an effort to eliminate these stark disparities in infant mortality, the Racial and Ethnic Approaches to Community Health across the U.S. (REACH U.S.) program was launched by the Centers for Disease Control and Prevention. Grantees are required to utilize community-based participatory approaches (CBPA) to establish coalitions and receive direction regarding key components of the program model. Additionally, CBPA is utilized to implement and evaluate respective program models to eliminate infant mortality disparities. The program models are designed to intervene on multiple levels of the socio-ecological model.

Results: To date, grantees developed community action plans for their respective communities. The three selected programs implement distinct models that identify key social determinants that contribute to infant mortality. Selected program components include cultural understanding, sensitivity, and relevance as well as integrated medical and social services. Additionally, environmental barriers to care and practitioner training are included.

Conclusions: While no single intervention is likely to eliminate racial disparities in infant mortality; it is important to identify key components that impact maternal health including social and environmental factors. Additionally, the period of pregnancy is too short to effectively address many risk factors important to infant health. However, a life-course perspective may improve infant mortality rates among African Americans.