Improving maternal and child health outcomes in the Mississippi Delta: Impact of the Delta Health Partner's Healthy Start Initiative

Background: Mississippi has the nation's highest infant mortality rate (IMR) at 10.2 deaths per 1,000 live births. Women and children in Mississippi experience significantly higher perinatal morbidity and mortality rates than other communities. In 2009, the infant mortality rate for whites was 7.0 deaths per 1,000 live births compared to 13.6 for blacks. This racial disparity has persisted throughout the preceding decade. The purpose of the Delta Health Partners (DHP) Healthy Start project is to improve perinatal health outcomes in a seven-county region of Mississippi Delta by strengthening the perinatal health care delivery system and establishing a new model of integrated perinatal health care services. Methods: Excess fetal and infant deaths were calculated from comparison of DHP categorical totals to MS reference group (white mothers who were ≥20 years of age and had ≥13 years of education) categorical values Results: A comparison of the DHP Service Area to the Non-Delta Service area in MS indicates a difference of 5.1 deaths or 1.4 times greater than Non-Delta populations in MS; 56.9% of the excess deaths were related to risk factors associated with Maternal Health/Prematurity; 15.8% of the excess deaths were attributed to risk factors associated with Infant Health. Public Health Implications: Interventions that promote maternal health improvement (e.g., preconception health, health behaviors, perinatal care and improve infant health activities (e.g., promotion of safe sleep, breast feeding, and injury prevention) have the greatest potential for improving perinatal outcomes.