Maternal child health policy resistance: The effect on the most vulnerable; the effect on the nation

Objectives: Despite an influx of financial and material resources to eliminate African American maternal child health disparities, the Non-Hispanic Black infant mortality rate continues to be more than twice that of Hispanic and Non-Hispanic Whites. Overall, there has been little change in the African American infant mortality rate since 1980. The purpose of this research is to identify factors which eliminate and/or decrease the effectiveness of policies designed to decrease African American infant mortality. Methods: A systems science approach was used to conduct a comprehensive, 5-year evaluation of maternal child health community programs. Process data, outcome data and data obtained from community-base participatory research (CBPR) methods were used to obtain information regarding the policy resistant nature of maternal child health policies. Result: Successful federal maternal child health policies are often incongruent with state maternal child health policies. Successful federal and state maternal child health policies have an impact on federal immigration policies and states abilities to comply with these policies. Successful federal and state maternal child health policies are incongruent with the African American culture of the women who depend on maternal child health assistance. Conclusion: African American infant mortality is not amenable to current policies and procedures which are primarily designed to increase access to prenatal services. This problem goes to the soul of the African American people and culture. Failure to recognize and respect the culture of this population is evidenced by stress, passive resistance, defiance and consistently high infant mortality rates.