Supersized Babies: A Care Coordination Approach

The Lucas County Initiative to Improve Birth Outcomes began as a result of the historical analysis of the high prevalence of low birth weight babies born in specific areas in central city Toledo, Ohio. In 2006, these percents were nearly twice that of the national low birth weight percentage (15.4% compared to 8.2%). This program represents a broad partnership of health and community organizations designed to identify those pregnant women most at risk to poor birth outcomes and connecting them to the health and social services they need to improve the health of their unborn children. The goals of the Initiative are to find those at risk (outreach), connect them to prenatal care and social services (care coordination), and measure the results. Four community organizations dedicate care coordination staff to improve birth outcomes by advocating for low income, high risk pregnant women and empowering them with resources and education. The Initiative funds the care coordinating organization when they reach the Initiative's goals of finding women at risk, connecting them to care and social services and delivering healthy birth weight babies. Since 2007, the Initiative has provided care coordination services for 634 pregnancies of 613 women. Low birth weights of this program population have decreased from 13% in 2008 to 6.5% in 2010. Care coordination services promote early identification and connection to prenatal care. It is a strategy to reduce barriers and address the significant social determinants of health. Care coordination can be a means to advance the future of equity.