Promising Practices for Reducing Racial Disparities in Infant Mortality in Michigan

LANSING - The W.K. Kellogg Foundation of Battle Creek recently awarded the Michigan Department of Community Health (MDCH) a $339,480 grant to develop and implement strategies to help reduce infant mortality and examine the racial disparity in the African-American and American-Indian populations.

African-American infants in Michigan continue to die prior to their first birthday at nearly three times the rate of white infants. In 2008 the black infant mortality rate was 14.6 per 1,000 live births, while the white rate was 5.4 per 1,000 live births. The infant mortality rate was 7.9 for American Indians.

"The generous support from the Kellogg Foundation will greatly assist our work to reduce health disparities in Michigan and improve the health status of Michigan's vulnerable families," said MDCH Director Janet Olszewski. "The project is designed to help public health professionals recognize the complexity of issues that impact health and incorporate that understanding in our daily work."

The Michigan infant mortality rate continues to be higher than the national rate. In 2008, the rate was 7.4. The provisional 2007 infant death rate for the United States is 6.8.

The project's goal is to identify and eliminate practices that have hindered any significant decline in the racial disparity of infant mortality in Michigan for more than 20 years. The work of the project will identify and implement an appropriate training model and curriculum, along with a tool-kit, that will promote understanding of practices that contribute to disparities in infant mortality for African-American and American-Indian infants, primarily the effects of institutionalized racism.

The intent of the project is to develop a quality assurance process that will include increased monitoring of social determinants of health: the social and economic conditions, in which people are born, grow, live, work and age. The key is to identify how the determinants impact infant mortality and implement strategies at the state, local and program levels to aid in decreasing the number of infant deaths in Michigan.

"The transformation of public health practice to a focus on social determinants of health will require movement and partnership at all levels of the public health system," said Ingham County Health Department's Deputy Director, Renee Canady. "At the local level, we have established a Coordinator of Health Equity and Social Justice. The existence of a similarly focused initiative at the state level holds great promise for advancing this agenda and ultimately eliminating health inequities in our state."

The tool-kit to be developed will include strategies and tools to promote continuous quality improvement, collaboration and accountability, and public sharing of measurable outcomes that reflect racial and health equity. Health equity is defined as a fair and just distribution of the social resources and social opportunities needed to achieve well-being.

"I feel that this initiative holds great promise because of its commitment to deep and multi-faceted exploration of policy and practice," said Elizabeth Kushman with the Inter-Tribal Council of Michigan. "The community partners engaged will offer the crucial perspective of the populations who experience the greatest health disparities. This initiative, much more so than many in the past, looks to acknowledge and understand the peoples true lived experience. This understanding is critical to inform and reform public health practice to better address health disparities."

Partnerships with local stakeholders are imperative to the success of the project. The department will embrace strategies to engage local health departments and other community organizations in MDCH's Bureau of Family, Maternal and Community Health's policy decision making. MDCH also will identify and utilize proven strategies that have been developed at both the local level and nationally.

The goals and objectives of the project are consistent with MDCH's vision that Michigan will be a safe and healthy state where all people realize their fullest health potential and live enriched and productive lives.

"Better understanding of the factors that cause health disparities will help improve the health outcomes of everyone," said MDCH's Maternal & Child Health Director, Alethia Carr.

This is a multi-year project and funding for additional years is being sought. For more information about the department's efforts to reduce infant mortality please visit http://www.michigan.gov/mdch.

The MDCH is responsible for health policy and management of the state's publicly funded health service systems. About 2 million Michigan residents will receive services this year that are provided with total or partial support from MDCH. The MDCH's, Bureau of Family, Maternal and Community Health is the state government authority for public health in Michigan that funds, assures, and set policy for maternal and child health services.

Project Partners Team Members

Michigan Department of Community Health, University of Michigan, The Corner Health Center, Wayne County Health Department, Ingham County Health Department, and Inter-Tribal Council of MI.

About the W.K. Kellogg Foundation - www.wkkf.org

Established in 1930, the W.K. Kellogg Foundation support children, families and communities as they strengthen and create conditions that propel vulnerable children to achieve success as individuals and as contributors to the larger community and society. Grants are concentrated in the United State, Latin America and the Caribbean, and southern Africa.