From problem to research to practice: Community-based strategies to eliminate black infant mortality in Hillsborough County, FL

In 2005, the Black Infant Mortality Rate in Hillsborough County, FL, was 4.4 times that of the White rate. In response to this disparity, and that throughout the state, Senator Arthenia Joyner and Representative Betty Reed sponsored House Bill 1269 (Fiscal Year 2007-2008) which created a practice collaborative to examine this disparity and make recommendations to the Legislature. Comprised of eight Florida counties and two public universities, the collaborative was charged with utilizing community engagement and mobilization and quantitative and qualitative research methodologies.

Community engagement and mobilization processes were primarily aimed at raising awareness and support from key Black stakeholders. The quantitative research methodology utilized a Perinatal Periods of Risk (PPOR) or similar conceptual framework. The qualitative component consisted mainly of focus groups and Fetal and Infant Mortality Reviews (FIMRs).

In Hillsborough County, the quantitative analyses revealed the highest rate of black feto-infant deaths occurred in the maternal health/prematurity period, relating to a woman's health prior to pregnancy. The second highest rate of deaths occurred in the infant health period, relating to the perinatal care delivery system and infant community health environment respectively.

Qualitative analysis determined that lack of education/information and barriers in access to care--insurance / Medicaid issues, lack of transportation and long wait times-- were strongly associated with black infant mortality.

As a result of the initiative's research findings, The Hillsborough Community Action Team developed and implemented a Speaker's Bureau and Save Our Babies Toolkit to address lack of education, particularly regarding the baby's health environment.