Reducing Racial Disparities
addressing Extreme Prematurity
Eliminating Sleep-Related Deaths
GOAL: Reduce Cuyahoga County's 2017 infant death disparity rate of 6.7 by 50 percent by the end of 2020 and to zero by 2025.
RESULTS TO DATE: The African American to Caucasian infant death disparity rate has decreased from 6.7 in 2017 to 4.12 in 2018, and increased slightly to 4.17 in 2019.*
GOAL: Develop, launch and execute an awareness and employee training campaign to address bias in the healthcare workplace that may negatively affect maternal and child health outcomes.
FYC Action Team 1 is comprised of representatives from the three major Cleveland health care systems, academia, public and private sectors, government and economic development organizations. Action Team 1 was charged with increasing awareness of inequities in care among Black, Latina, and white women who receive prenatal, birth care, and postnatal care at our local health care systems.
To build a foundation for their work, FYC Action Team 1 held a number of focus groups to learn about patient experiences. They found that Black women and Latinas reported they did not feel their health care providers listened to their concerns, even going so far as to dismiss their concerns as inconsequential. From there, the group used the data from the focus groups to create a journey map illustrating the pain points that the participants experienced throughout their pregnancy.
The knowledge gained from the focus groups and journey mapping aided in the development of an awareness campaign that is currently being implemented in Cuyahoga County’s three major health care systems. This campaign, which includes a series of interactive posters and videos, informs health care systems’ leadership and staff members on how personal biases negatively impact maternal and child health as well as interventions that address these biases.
With funding from the Ohio Department of Medicaid, FYC Action Team 1 also arranged for the training of 28 individuals from multiple health care systems, preparing them to deliver Cook Ross designed Everyday Bias for Healthcare Professionals workshops. As of February 2020, more than 300 department leaders, human resource departments, CenteringPregnancy® staff members, OB/GYN providers, and other clinicians participated in this training to discover how biases impact maternal and infant health outcomes.
This work is beginning in the hospitals and will expand to the private and public sectors. It is foundational work to address bias and inequities within our local organizations by further examining hiring practices, training protocols, and board diversity.
GOAL: Gain insight from African American families that have experienced a loss in order to develop programming and policy solutions.
Recent Accomplishments: Over the last year, grief recovery sessions, remembrance events and community wellness activities have engaged parents and extended family who have experienced a miscarriage, stillbirth or loss of an infant. The Black Infant Loss Society was established as a support network for families. Healing Circles were launched to help families connect to culturally appropriate mental health services and providers. The Pregnancy and Infant Loss website (pailconnect.org) and social media pages (@PAILConnectCLE) have been created, with community resources, upcoming events and more. The PAIL team completed, in collaboration with the Healthy Neighborhoods Committee of Healthy Cleveland, "Toxic: A Black Woman's Story." This short film highlights the effects of racism and toxic stress on maternal and child health outcomes. A film discussion guide was also developed, in partnership with Debra Adams Simmons of National Geographic. The guide is designed to accompany the film and foster meaningful conversations. The film and discussion guide are available for purchase at https://toxicshortfilm.com/. “Toxic” premiered on September 25, 2019 and will now be shown locally at select venues and used to educate health care and social services providers.
Sabrina Roberts, Cuyahoga County
Tracy Carter, Summa Health
GOAL: Lead research efforts to better understand the roles race and maternal stress play in infant deaths.
Recent Accomplishments: Birthing Beautiful Babies is an interventions research designed to reduce race-related and other stressors in expectant African American mothers. The intervention consisted of a seven-week doula led sister collective based on the book, Soothe Your Nerves: The Black Woman’s Guide to Understanding and Overcoming Anxiety, Panic, and Fear. In these groups, women received culturally relevant programming, education and advocacy designed to reduce race-related risk factors for low-birthweight and pre-term infants. Participants were followed for one year and contacted quarterly. The quantitative and qualitative data indicated that mothers greatly benefitted from the intervention. They learned and implemented tools to reduce stress and to cope with race-based and relationship stress in meaningful and productive ways. Their husbands, partners and other members of their sister collective also noted the changes. Most importantly, the women formed a kinship bond that continued outside of the meetings.
Christin Farmer, Birthing Beautiful Communities
Angela Neal Barnett, Kent State University
GOAL: Coordinate an integrated equity model with housing, education, research, health care, and public sector leaders to address the link between structural racism and infant deaths. Determine what must be done to eliminate barriers resulting from these economic and social conditions.
Dr. Arthur James, First Year Cleveland
Margaret Mitchell, YWCA Greater Cleveland
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