Infant Mortality: Transforming Awareness Into Action
Infant mortality awareness month is coming to a close, but the work to protect infants and their families must continue. As many are acutely aware, infant mortality is an ongoing crisis in this country and disproportionately affects Black families. The disparities reported in data from the Centers for Disease Control and Prevention (CDC) are staggering: for Black infants, the national rate is 11.3 per 1,000 births while the cumulative national rate for all races and ethnicities is 6.1 per 1,000. These rates jump to almost 14 per 1,000 in some states for Black infants – most notably in Wisconsin, Alabama, Ohio and Washington D.C.
As part of a health equity agenda that crosses sectors well beyond health care alone, advocates should continue to focus on birth outcomes as an essential health priority. Health advocates can help by supporting and advancing promising practices and programs that support infants and by targeting resources to invest in prenatal, interception and postnatal care of women, infants and caregivers. Further, advocates can be vocal about the importance of dismantling programs and policies that reinforce and perpetuate structural racism, a driver of infant mortality disparities. Below are some key federal priorities for the remainder of 2018 that advocates can pursue to transform infant mortality awareness into action:
- Support and participate in actions related to the bipartisan piece of legislation, the Preventing Maternal Deaths Act of 2017, H.R.1318 in the House, and the Maternal Health Accountability Act of 2017, S.1112 in the Senate. A September hearing was postponed and will be rescheduled. This is a great opportunity to support federal policy focused on data collection and surveillance. Data collection and analysis is an important step in advancing health equity, ensuring that programs and policies are targeting resources accurately. Requiring states to collect and review maternal mortality data is of paramount importance. Sign on here.
- Support and participate in actions related to the Maternal Care Access and Reducing Emergencies (CARE) Act. The CARE Act was introduced by Kamala Harris and 13 Democratic colleagues on August 22of this year. The bill is directly aimed at reducing racial disparities in maternal mortality and morbidity, which are intimately related to infant outcomes. The bill creates Implicit Bias Training Grants for medical schools, nursing schools and other health professional training programs. It also establishes grants for Pregnancy Medical Home Demonstration Projects that would incentivize maternal health care providers to deliver integrated health care services to pregnant women and new mothers.
- Make infant mortality and maternal health an issue for voters. Medicaid is an important coverage program for women and infants, providing them with access to needed services, including newborn care and maternal depression screening. Research shows that healthy caregivers can lay the groundwork for the long-term health for their children – Medicaid is the leading source of coverage for over 40 million women. Ensuring that candidates support a robust Medicaid program and will protect the program against cuts and financial restructuring is important to infant and maternal health. Further, Medicaid waivers that seek to impose work requirements would have negative impacts on women, mothers and infants by eliminating their access to the Medicaid program because women who work low-wage jobs with fluctuating hours and/or are caregivers may not meet these work requirements. Learn more here.
- Support efforts to protect family planning. Over the summer, the Trump administration issued a new Title X rule that would dramatically alter the nation’s only public family planning program and limit access to essential family planning services. The rule entered a comment period that ended July 31. Read about the proposed changes here. Stay alert to the final rule and get involved in actions against it.
- Support key provisions that protect women and infants in the pending opioid bill. The House and Senate have each passed a version of a substance use disorder response bill (S.2680 Opioid Crisis Response Act of 2018 and H.R.6 SUPPORT for Patients and Communities Act). Each of these bills contains provisions that aim to promote resilience for children, families and their communities. These provisions include a variety of tools including funding substance use treatment for pregnant women and establishing trauma-informed care policies in provider education. It is critically important to protect women with addictions from punitive policies that hurt them instead of providing them needed services. Support the bipartisan legislation by telling your members of Congress to keep provisions that protect women and infants.
Black infants should not die at twice the rate of white infants. Dismantling the structures and inequities that drive this data point should guide and define our advocacy work. In addition to the federal agenda listed above, this work includes lending our voices to promoting change in policies outside the health sector that contribute to high rates of infant and maternal mortality. A robust birth outcomes agenda must be multifaceted. It requires listening to Black women about their birthing experiences, tailoring programs and policies to meet families’ needs and working across sectors to address other contributing factors to adverse health outcomes. These other factors include healthy housing, nutrition, economic opportunity and access to education. But most importantly, this work requires acknowledgement that breaking down systems of structural racism is essential to progress on every aspect of this problem.
Supporting federal work that moves us toward monitoring disparities, targeting needed services and supports to pregnant women and infants and protecting Medicaid as a key coverage program will together make for a healthy start.
Tess Solomon, Intern with Community Catalyst’s Women’s Health Program, co-authored this blog