142nd APHA Annual Meeting and Exposition

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Improved Birth Weight for Black Infants: Outcomes of a Health Start Program

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 12:30 PM - 12:50 PM

Arthur James, MD , Obstetrics and Gynecology, Ohio State University, Columbus, OH
Audio (mp3) recording Recorded Presentation (mp4)
Objectives. To determine whether participation in Healthy Babies Healthy Start (HBHS), a maternal health program emphasizing racial equity and delivering services through case management home visitation, was associated with improved birth outcomes for Black women relative to White women.

Methods. We used a matched-comparison posttest-only design in which we selected the comparison group using propensity score matching. Study data were generated through secondary analysis of Michigan State- and Kalamazoo County–level birth certificate records for 2008–2010. We completed statistical analyses, stratified by race, using a repeated-measures generalized linear model.

Results. Despite their smoking rate being double that of their matched counterparts, Black HBHS participants delivered higher birth-weight infants than Black nonparticipants (p=.05). White HBHS participants had significantly more prenatal care than White nonparticipants, but they had similar birth outcomes (p=.70 for birth weight, p=.55 for gestation).

Conclusions. HBHS participation is associated with increased birth weights among Black women but not among White women, suggesting differential program gains for Black women.

Learning Areas:

Diversity and culture
Epidemiology
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe a method for assessing program impact upon racial disparity in birth outcomes Discuss the results of such an assessment in one community

Keyword(s): Infant Mortality, Birth Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As an Obstetrician/Gynecologist and Pediatrician I was the founding Medical Director of the Kalamazoo County Healthy Start Program and, along with our Healthy Start efforts, helped to lead a community infant mortality reduction effort that reduced black infant mortality in Kalamazoo County from 29.7 to 10.2, making Kalamazoo County one of few United States Counties to achieve HP-2000 Black Infant Mortality Rate goals.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3217.0: Evidence Based Outcomes of the Healthy Start Program