On the bench and in the trench: Experiences in an African American infant mortality reduction program

The Genesee County, Michigan REACH US initiative is a CDC funded collaborative project between local health infrastructures, community based organizations, and universities to reduce the disparity in African American infant mortality. The REACH US Community Action Plan was generated using a community-based participatory approach and is based on a socio-ecological model with interventions at the individual, health system, and community levels. African American infant mortality in Genesee County declined to a historic low in 2005 and rates remain lower than in previous years. REACH partners believe that no single intervention or activity can be credited for this effect, but that efforts focusing on multiple levels of the socio-ecological model have had a synergistic effect. This presentation will document how the REACH partnership activities incorporate APHA 2010's meeting theme “Social Justice: Public Health Imperative.” We will also describe the experiences and perspectives of the African American health department staff members who manage the program. Despite the successes in the program, the project has faced considerable challenges originating externally, internally, and with the interaction of external and internal issues. For example, the project's funding was threatened due to incompatibilities between the funding agency's expectations and local officials' interpretations of health policies. Although this issue arose from outside the project partnership, it resulted in tensions among project partners. This situation may have been particularly adverse for African American health department staff members, who represent both the health care infrastructure and the community the intervention is designed to serve. (This abstract is a sufficient summary of the proposed presentation.)