Using Collective Impact to Develop a Community-Led Initiative for Improving Black Infant Mortality

2021 ◽  
pp. 152483992110613
Author(s):  
Rauta Aver Yakubu ◽  
Darcell P. Scharff ◽  
Lora Gulley ◽  
Rhonda BeLue ◽  
Kimberly R. Enard
Keyword(s):  
Infant Mortality ◽  
Lived Experience ◽  
Developed Countries ◽  
The United States ◽  
Mortality Rates ◽  
Collective Impact ◽  
Participatory Approaches ◽  
Race Disparities ◽  
Adverse Pregnancy ◽  
Black Infant

The United States has one of the highest infant mortality rates among developed countries. When stratified by race, disparities are more evident: Black infant mortality rates are 2.5 times higher than non-Hispanic white infants. Structural, systemic racism is a contributing cause for these racial disparities. Multisector collaborations focused on a common agenda, often referred to as collective impact, have been used for infant mortality reduction interventions. In addition, community-based participatory approaches have been applied to incorporate those with lived experience related to adverse pregnancy outcomes. This article critically describes the transition of an infant mortality collective impact initiative from being led by a multisector organizational group to being community led over a 5-year period, 2015–2020. A 34-member community leaders group was developed and determined four priorities and corresponding strategies for the initiative. Findings show that community participatory approaches are a way to address racial equity for public health initiatives.

In Reply: Mortality Rates

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 403-403
Author(s):  
MYRON E. WEGMAN
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Developed Countries ◽  
The United States ◽  
Mortality Rates ◽  
National Average ◽  
Population Groups ◽  
Relative Ranking

Dr Babson's thoughtful letter raises at least two important points about how the United States can achieve decreased infant mortality for all its citizens: (1) how significant is relative ranking among developed countries, of which some are relatively homogeneous and other heterogeneous, and (2) the importance of decreasing mortality among those US population groups with rates greater than the national average. On the first point, as I have pointed out in earlier articles, relative ranking is important, in my view, chiefly as indicating how much better we can do.

Annual Summary of Vital Statistics—1991

PEDIATRICS ◽  
1992 ◽  
Vol 90 (6) ◽  
pp. 835-845
Author(s):  
Myron E. Wegman
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Divorce Rate ◽  
The United States ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Natural Increase ◽  
Infant Mortality Rate ◽  
Marriage Rates ◽  
Final Data

Between 1990 and 1991, provisional data show that the infant mortality rate decreased again, from 9.1 to 8.9, a decline of 2% in contrast to the 7% decline from 1989 to 1990. Birth, death, and marriage rates were also lower, but the divorce rate stayed at about the same level as in 1990. Natural increase in the population, excess of births over deaths, was less than 2 million, 4% less than the increase in 1990. Detailed analysis of changes and of the influence of factors like age and race requires final data; at the time of preparation of this report final birth and death data were available only through 1989. For a variety of reasons, including staff shortages and delays in receipt of state data by the National Center for Health Statistics (NCHS), final data for 1990, which would usually have been available in late August 1992, are not expected before early 1993. Unlike recent years, the decline in the infant mortality rate was only in the neonatal component, which decreased 3.6%. Postneonatal mortality increased, for the first time in many years, by 1.6%, suggesting that the decline in the total is related more to therapeutic advances in neonatology than to improved prevention. Internationally, newly independent Latvia was added to the list of countries with rates less than 15, but Costa Rica was deleted. With the reunification of Germany the list shrank to 28 and, by default, the United States moved up from 21st to 20th. Some 12.5 million births, less than 9% of the world total, took place in countries with under-5 mortality rates of less than 20 per 1000. At the other end of the scale, 42% of the world's births occurred in countries with under-5 mortality rates of more than 140 per 1000. The median under-5 mortality rate for those countries in 1990 was 189 per 1000, meaning that almost 20% of the infants born alive in these countries died before their fifth birthday.

Annual Summary of Vital Statistics—1993

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 792-803 ◽  
Author(s):  
Myron E. Wegman
Keyword(s):  
Infant Mortality ◽  
Death Rate ◽  
The United States ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Infant Mortality Rate ◽  
Chronic Obstructive ◽  
Percentage Increase ◽  
Birth Rates ◽  
Older Mothers

A new low in the infant mortality rate was reached again in 1993, at 828.8 deaths per 100 000 live births, a decline of 2% from 848.7 in 1992. Births, marriages, and divorces were all lower, both in number and rate. Deaths and the death rate, however, both increased and, more significantly, the age-adjusted death rate increased. A likely explanation is the occurrence of influenza epidemics in early and late 1993. The rate of natural increase declined 8%, to a level of 6.9 per 1000 population. Final figures on births for 1992 indicate that, for the first time in many years, birth rates to teen-agers declined, more among black mothers than white. Increase in birth rate among older mothers continued at a somewhat slower rate than recently; older mothers tended to be better educated than the general population in their age groups. Total fertility rates were higher among mothers of Hispanic origin than among non-Hispanic blacks who, in turn, had higher rates than non-Hispanic whites. Among Hispanics the highest rates were in those of Mexican origin. Unlike recent years, birth rates to unmarried mothers did not increase in 1992. Prenatal care coverage improved, with more mothers seeking care early and fewer receiving late or no care. Electronic and fetal monitoring was performed on more than three-quarters of all births and ultrasound on more than half. Life expectancy decreased slightly, in contrast to recent years. Among major causes of death, increases were recorded in 1993 for chronic obstructive pulmonary diseases, pneumonia and influenza, and HIV infection, the latter having the largest percentage increase. Internationally, infant mortality rates in most other industrialized countries declined further in 1992. Comparatively, as in 1991, 21 other countries had infant mortality rates lower than the United States.

scholarly journals The evolution of infant mortality inequality in the United States, 1960–2016

2020 ◽  
Vol 6 (29) ◽  
pp. eaba5908
Author(s):  
Nick Turner ◽  
Kaveh Danesh ◽  
Kelsey Moran
Keyword(s):  
United States ◽  
Infant Mortality ◽  
The United States ◽  
Mortality Rates ◽  
County Level ◽  
Level Data ◽  
Antipoverty Programs ◽  
The Relationship ◽  
Over Time ◽  
Mortality Inequality

What is the relationship between infant mortality and poverty in the United States and how has it changed over time? We address this question by analyzing county-level data between 1960 and 2016. Our estimates suggest that level differences in mortality rates between the poorest and least poor counties decreased meaningfully between 1960 and 2000. Nearly three-quarters of the decrease occurred between 1960 and 1980, coincident with the introduction of antipoverty programs and improvements in medical care for infants. We estimate that declining inequality accounts for 18% of the national reduction in infant mortality between 1960 and 2000. However, we also find that level differences between the poorest and least poor counties remained constant between 2000 and 2016, suggesting an important role for policies that improve the health of infants in poor areas.

Comparison of Neonatal and Infant Mortality Rates between Infants Born in South Korea and Those Born in the United States

2014 ◽  
Vol 21 (4) ◽  
pp. 211 ◽  
Author(s):  
Ji Sun Lee ◽  
Jung Min Yoon ◽  
Eun Jung Cheon ◽  
Kyong Og Ko ◽  
Jae Won Shim ◽  
...  
Keyword(s):  
United States ◽  
Infant Mortality ◽  
South Korea ◽  
The United States ◽  
Mortality Rates

Regional Contribution of Previable Infant Deaths to Infant Mortality Rates in the United States

2019 ◽  
Author(s):  
MacKenzie Lee ◽  
Eric S. Hall ◽  
Meredith Taylor ◽  
Emily A. DeFranco
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Infant Death ◽  
The United States ◽  
Mortality Rates ◽  
Population Based ◽  
Infant Mortality Rate ◽  
Infant Deaths ◽  
Live Births ◽  
Healthy People 2020

Objective Lack of standardization of infant mortality rate (IMR) calculation between regions in the United States makes comparisons potentially biased. This study aimed to quantify differences in the contribution of early previable live births (<20 weeks) to U.S. regional IMR. Study Design Population-based cohort study of all U.S. live births and infant deaths recorded between 2007 and 2014 using Centers for Disease Control and Prevention's (CDC's) WONDER database linked birth/infant death records (births from 17–47 weeks). Proportion of infant deaths attributable to births <20 vs. 20 to 47 weeks, and difference (ΔIMR) between reported and modified (births ≥20 weeks) IMRs were compared across four U.S. census regions (North, South, Midwest, and West). Results Percentages of infant deaths attributable to birth <20 weeks were 6.3, 6.3, 5.3, and 4.1% of total deaths for Northeast, Midwest, South, and West, respectively, p < 0.001. Contribution of < 20-week deaths to each region's IMR was 0.34, 0.42, 0.37, and 0.2 per 1,000 live births. Modified IMR yielded less regional variation with IMRs of 5.1, 6.2, 6.6, and 4.9 per 1,000 live births. Conclusion Live births at <20 weeks contribute significantly to IMR as all result in infant death. Standardization of gestational age cut-off results in more consistent IMRs among U.S. regions and would result in U.S. IMR rates exceeding the healthy people 2020 goal of 6.0 per 1,000 live births.

Happiness for All?

2017 ◽  
Author(s):  
Carol Graham
Keyword(s):  
Well Being ◽  
Developed Countries ◽  
The United States ◽  
Mortality Rates ◽  
Material Deprivation ◽  
Pursuit Of Happiness ◽  
Poor Whites ◽  
Divided Society ◽  
The World ◽  
Job Instability

The Declaration of Independence states that all people are endowed with certain unalienable rights, and that among these is the pursuit of happiness. But is happiness available equally to everyone in America today? How about elsewhere in the world? This book draws on cutting-edge research linking income inequality with well-being to show how the widening prosperity gap has led to rising inequality in people's beliefs, hopes, and aspirations. For the United States and other developed countries, the high costs of being poor are most evident not in material deprivation but rather in stress, insecurity, and lack of hope. The result is an optimism gap between rich and poor that, if left unchecked, could lead to an increasingly divided society. The book reveals how people who do not believe in their own futures are unlikely to invest in them, and how the consequences can range from job instability and poor education to greater mortality rates, failed marriages, and higher rates of incarceration. The book explains why the least optimistic people in America are poor whites, not poor blacks or Hispanics. This book highlights the importance of well-being measures in identifying and monitoring trends in life satisfaction and optimism—and misery and despair—and demonstrates how hope and happiness can lead to improved economic outcomes.

Letter To The Editor

PEDIATRICS ◽  
1970 ◽  
Vol 45 (6) ◽  
pp. 1044-1044
Author(s):  
Alfred Yankauer
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Infant Death ◽  
The United States ◽  
Mortality Rates ◽  
European Countries ◽  
Death Rates ◽  
Letter To The Editor

Second, Dr. Yankauer: "Disgraceful and totally unacceptable" are inflammatory adjectives. They stir up uncomfortable feelings of personal guilt and blame. It would be reassuring if the differences between infant mortality rates in the United States and those of several small European countries with relatively homogenous populations and stable traditions could be explained away as statistical artefacts. Unfortunately the differences cannot be explained away. Clear evidence for their substance is the fact that infant death rates after the first month of life are three times as high in the United States as in Sweden.

Infectious Disease-Related Deaths of Low Birth Weight Infants, United States, 1968 to 1982

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 296-303
Author(s):  
Janine M. Jason
Keyword(s):  
Infectious Disease ◽  
United States ◽  
Birth Weight ◽  
Infant Mortality ◽  
Low Birth Weight ◽  
Infectious Diseases ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Tract Infections

Infant mortality rates in the United States are higher than in any other developed country. Low birth weight (LBW) is the primary determinant of infant mortality. Despite city, state, and federal programs to prevent LBW, decreases in infant mortality in the 1980s appear to be largely secondary to improved survival of LBW infants rather than to a decline in the rate of LBW births. Because prevention of mortality due to infectious disease is feasible, it was of interest to examine the role of infectious diseases in LBW infant mortality. US vital statistics mortality data for 1968 through 1982 were analyzed in terms of LBW infant mortality associated with infectious and noninfectious diseases. These analyses indicated that the rates of infectious disease-associated early neonatal and postneonatal LBW mortality increased during this time; late neonatal rates did not decline appreciably. Infectious diseases were associated with 4% of all LBW infant deaths in 1968; this had increased to 10% by 1982. Although LBW infant mortality rates associated with noninfectious diseases did not differ for white and black populations, infectious disease-associated mortality rates were consistently higher for blacks than whites in both metropolitan and nonmetropolitan areas. Chorioamnionitis was involved in 28% of infectious disease-associated early neonatal LBW deaths. Sepsis was an increasingly listed cause of death in all infant age periods, whereas respiratory tract infections were decreasingly listed. Necrotizing enterocolitis increased as a cause of late neonatal mortality. These data suggest that infectious diseases are an increasing cause of LBW infant mortality and these deaths occur more frequently in the black population targeted by prevention programs. More research concerning specific causes and prevention of infections in the LBW infant may help reduce US infant mortality.

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