Exploring infant mortality social determinants of health among young women to inform community change

Introduction Social influences impact behavior, including the health of women before and during pregnancy. Social determinants of health have been identified and are well known, yet comprehensive community solutions to improve health outcomes remain limited. The features of one's environment impact preconception health, although to what extent and how these features interact is less known. Methods Mothers aged 25 years and younger who had lost a child anytime before the age of one year old were invited to participate in a series of focus groups about their loss, preconception health, and community solutions. During focus groups the mothers discussed their own health status and their community including: social support, available resources and barriers. Participants were also asked to create solutions for their own communities (e.g., neighborhoods) and react to several proposed solutions including preventive care via a mobile primary care office. Results The focus groups identified several community resources and services that would increase the likelihood of accessible care and support. Access to primary care (e.g., birth control) was identified as an important need. In addition, those participants who had a strong social network were less likely to report poor health outcomes since the loss of their child. Discussion The findings provided preliminary data to support a comprehensive community solution to the high number of infants that die each year in Sedgwick County Kansas. This formative research grounded in public health theory is one example of providing a voice to those who are often of greatest need.