Addressing the Black Infant Mortality Crisis in Wisconsin

t’s a shocking disparity: in Wisconsin, the overall infant mortality rate is 5.92% (comparable with national averages), but the mortality rate of non-Hispanic African American infants is the highest in the nation, at 14.28%. (source)

That means black babies in Wisconsin are almost three times as likely to die before their first birthday than their white counterparts. The number-one cause: complications of prematurity.

And although factors contributing to this pressing health inequity are complex, previous research has shown that in Dane County, belonging to a community of color and a lack of social support and culturally relevant prenatal support are barriers to effective care and optimal health outcomes for mother-baby dyads. (source).

Jasmine Zapata, MD, MPH (assistant professor, Division of Neonatology and Newborn Nursery), recently received a two-year, $150,000 grant from the New Investigator Program at the University of Wisconsin School of Medicine and Public Health’s Wisconsin Partnership Program to pilot a unique community-based prenatal care model for African American women and infants in Dane County.

Community Driven and Culturally Relevant

The model, the “Today Not Tomorrow Pregnancy and Infant Support Program,” builds on emerging evidence about how to effectively implement and sustain prenatal care in black communities.

It combines three approaches—community-based doula programs; group-based models of prenatal care, such as Centering Pregnancy; and community-based pregnancy support groups—into monthly group sessions held during the prenatal and immediate postpartum period.

The project is based at the Today Not Tomorrow Family Resource Center in Madison’s East Side Community Center, and carried out in close collaboration with Project Babies, Harambee Village Doulas, and the African American Breastfeeding Alliance of Dane County, Inc.

Participants also receive one-on-one visits with community doulas, culturally sensitive mental health and case management support services on an as-needed basis, and the option to receive prenatal care exams on site.

 “This program is unique because it’s led completely by women of color,” explains Dr. Zapata. “It’s community driven, group based, family centered and culturally relevant.”

In addition to assessing the program’s feasibility and acceptability, Dr. Zapata will also capture initial evidence on indicators of maternal-child health, such as breastfeeding initiation and continuation, awareness and use of community doulas, perceived social connection and satisfaction with care delivered through the model.

“Ultimately, my goal is to decrease racial inequities in preterm birth and infant mortality in Wisconsin through system and policy change,” Dr. Zapata says. “This program is not the sole solution to such a complex problem, but innovative research in the field is critically needed, and this is a step in the right direction.”