Ensuring Infant Health
Work by New Haven Healthy Start and others have helped to significantly lower infant mortality rates. Yet the rates among African Americans and in low-income neighborhoods remain well above the rest of the region and twice the national public health target.
Back in the mid-1980s, studies revealed that the infant mortality rate for African American babies in New Haven was higher than in many underdeveloped countries. The data prompted a city-wide call to action. Leaders and public health experts were convened by The Community Foundation for Greater New Haven to form The Commission on Child and Infant Health, which began an initiative that led to the creation of New Haven Healthy Start (NHHS).
Birth outcomes by the numbers
In the mid-to-late 1980s, there were 20 deaths per thousand births in New Haven and a rate of 31 deaths per thousand births for New Haven African Americans1.
Work by New Haven Healthy Start and others have since helped to significantly lower infant mortality rates. Recent studies show rates of 7 deaths per thousand births in New Haven overall.2 In the inner-ring suburbs, the infant mortality rate is 6 deaths per 1,000 births, while the rate in the outer-ring suburbs is 5 deaths per 1,000 births.3 By comparison, the state average over this period is 5 per 1,000 and the Federal Government's Healthy People 2020 target is 6 per 1,000 births.
Low birth weight increases the risk of fetal and infant mortality as well as chronic health conditions. In New Haven, 9.5% of the babies were born with low birth weight as compared to state and national averages of 8 percent4.
The cost of preterm birth and low birth weight
- The average cost of caring for a preterm baby in the NICU is estimated to be $79,000. In comparison, the average hospital charge for providing care to a healthy newborn is $1,5005
- Low birth weight children are 50% more likely than normal birth weight children to need special education programs at an estimated per pupil cost of $3,5556
- Low birth weight children are more likely to repeat a grade in school, which is estimated to have a per-pupil cost of $4,0006
Root Causes
Advocates and researchers have tied the poor outcomes to several factors including smoking, substance abuse, poor nutrition, lack of prenatal care, medical problems, chronic illness, sudden infant death syndrome (SIDS), and the stresses of daily life, including racism.
While many of these factors disproportionately affect poor women, racism affects African American women across the socio-economic spectrum7. Where individuals live also affects their health8.
A Strategic Focus
New Haven Healthy Start has worked to improve infant health by reaching out directly to the mothers in need.
"We got really strategic and specific to the African American population. We needed an aggressive approach to African American women," says Healthy Start Consortium Development Coordinator Natasha Ray."We have 'Baby Buddies' who act like a supportive next door neighbor," says Ray. "If they see someone in need of care, they notify us. We're trying to raise awareness everywhere we can."
New Haven Healthy Start has expanded its program from working with the city's hospitals and health centers to include homeless shelters and the city's housing authority. It also emphasizes addressing social determinants of health and works with community-based organizations that strengthen family resiliency. It also supports father engagement through a Men's Consortium.
The work is resulting in better birth outcomes for women who are involved in NHHS. The overall infant mortality rate among program participants from 2005 to 2009 was 4.0 deaths per 1000 live births. The percentage of low birth weight infants born to program participants during 2009 was 6%9 compared to 11% of births to New Haven residents in 2008.10
New Haven Healthy Start program participants continue to experience better birth outcomes compared to women in similar cities throughout Connecticut. Approximately 80% of program participants are residents of New Haven while the remaining 20% are from surrounding towns, including West Haven, East Haven and Hamden.11
Supporting a Healthy Environment
Yaritza Roman, a NHHS Outreach/Case Manager working with New Reach, uses a low pressure approach to help guide homeless women along in their pregnancies so they meet their prenatal appointments and eat healthy food.
"I always try not to make our meetings clinical," Roman says. "It's more casual, so the moms open up. . . And we provide incentives to ensure a healthy start-- new pajamas, brand new books, baby baskets. It's about building a relationship."
Roman says the women are stressed because of their own lack of housing and challenge in feeding themselves and their other children. Many are also survivors of domestic violence or sexual abuse.
"The last thing they're thinking of is themselves. I think this program provides specific support just for that; I think just being there. It's not until someone reminds them, 'You're important too!' that they realize they have to take care of themselves so they can take care of their families."
What the Community Foundation is Doing
After convening the Commission on Child and Infant Health, The Community Foundation applied for federal funding to start a Healthy Start program in New Haven. Since receiving its first federal grant in 1997 to begin New Haven Healthy Start, The Community Foundation has raised nearly $22 million to administer the program. From then to now, the NHHS team has been working to reduce the infant mortality and morbidity rate in the City of New Haven, providing services to more than 20,000 pregnant women and infants through partnerships with maternal and child health care providers to identify gaps in the delivery of prenatal and post-natal care.
Members of the NHHS Consortium of Care include the New Haven Health Department, Yale-New Haven Hospital, Cornell Scott-Hill Health Center, Fair Haven Community Health Center, New Haven Family Alliance (Male Involvement Network), New Haven Home Recovery, Diaper Bank, Christian Community Action, Life Haven Shelter Inc., Community Action Agency, Yale School of Medicine, Yale Consultation Center, Connecticut Voices for Children, New Haven Housing Authority and the CT Department of Public Health.
Works Cited
1. More infants can be saved: City renews health attack on preventable deaths New Haven Register Editorial, 1/21/01
2. Abraham, M, et al. (2013). Greater New Haven Community Index 2016. DataHaven, 22.
3. ibid
4. ibid
5. March of Dimes Peristats: www.marchofdimes.com/peristats
6. E. Lewit, L Baker, H Corman, P. Shiono, The Direct Cost of Low Birth Weight. The Future of Children Brookings Institute (1995)
7. African American Infant Mortality Commission Fact Sheet; Joint Center for Political & Economic Studies - Health Policy Research & Publications
8. Why Place Matters: Building the Movement for Healthy Communities
9,11. Data Source: The Community Foundation for Greater New Haven, New Haven Healthy Start Program Database
10. Data Source: Connecticut Department of Public Health, Vital Statistics, 2008, via website: www.ct.gov
Other Resources:
National Healthy Start Association
Association of Maternal and Child Health Programs
© The Community Foundation for Greater New Haven
January 2014
