New effort to tackle Black infant mortality
Allegheny Health Network introduces ‘First Steps and Beyond’ initiative
In Pittsburgh, Black infants are more than four times as likely than white babies to die before they reach their first birthday. This grim gap is the reason for a new initiative launched by Allegheny Health Network called First Steps and Beyond. The program aims to monitor the health and well-being of African American parents and their babies through the first year of life by expanding prenatal, perinatal, birthing and fatherhood services to residents. In doing so, it hopes to slash infant mortality of Black babies by at least 28% over the next five years.
“Our vision is to ensure that all babies born in Allegheny County celebrate their first birthday, and an important part of achieving this goal is reducing the rates of Black infant mortality, which are unacceptably high right now,” said Elissa Edmunds-Hunt, who joined AHN in February to lead the new program.
Before coming to AHN, Ms. Edmunds-Hunt oversaw a perinatal program for extremely high-risk pregnant people in Washington, D.C., and worked to address Black maternal health disparities in the region.
In Pittsburgh, 13 of every 1,000 Black babies die before they turn a year old compared with fewer than three per 1,000 white babies, according to a 2019 report by the city’s Gender Equity Commission. For non-Black babies, Pittsburgh has fewer infant deaths than the vast majority of other U.S. cities, the study found. Male Black infant mortality in Pittsburgh is average, but female Black infant mortality is higher than 70% of similar cities.
For Black women in the city, 18 out of every 1,000 pregnancies end in a fetal death — that is, a death before birth — compared to only 9 out of every 1,000 white pregnancies, according to the report.
Ms. Edmunds-Hunt will work with local universities, nonprofits, doulas and other groups to reduce racial disparities, address extreme prematurity, eliminate preventable sleep-related infant deaths and expand postpartum support to mothers.
“The hope is that we can build really meaningful and sustainable partnerships with organizations around the city and have a unified front on how we’re going to address these disparities,” she said.
What parents can do
One piece of the program will be educating parents on unsafe sleeping practices, a major contributor to infant mortality. One immediate step parents can take is to place babies on their backs alone in a crib, she said.
According to the National Institutes of Health, this is the single most effective action that parents and caregivers can take to lower a baby’s risk of sudden infant death syndrome, an unexplained death of a seemingly healthy baby less than a year old. Ms. Edmunds-Hunt said parents should also refrain from smoking near their babies or even wearing clothing that smells like smoke around their infants.
There should be no loose bedding or toys in the crib, according to the NIH’s Safe to Sleep campaign
Some families may not be able to take these preventive measures because of unsafe or unstable living conditions. The program is hoping to develop interventions to help families experiencing unsafe housing and other hardships.
“Not having a safe place for babies to sleep is a huge factor in infant mortality,” Ms. EdmundsHunt said.
The so-called social determinants of health — conditions in the places where people live, learn, work and play — play a major role in infant mortality. In addition to unsafe housing, these could include food insecurity and domestic violence, which are all experienced by Black residents at higher rates.
In Pittsburgh, 13 of every 1,000 Black babies die before they turn a year old compared with fewer than three per 1,000 white babies. — 2019 report by the Pittsburgh Gender Equity Commission
What health care providers can do
There are other factors beyond parents’ control that contribute to the risk of infant mortality, Ms. Edmunds-Hunt said. For instance, medical racism and bias can mean that doctors may be dismissive of Black patients and their health concerns, whether consciously or unconsciously. To address this issue, First Steps and Beyond will provide training and education on the history of racism in medicine to physicians, nurses and other health care professionals who interact directly with patients.
Dr.Margaret Larkins-Pettigrew, senior vice president and chief clinical officer of diversity, equity and inclusion for AHN and Highmark Health, said she hopes the new program will be able to bring together various initiatives across the city and county to work toward the common goal of reducing Black infant mortality.
“We think we will see significant outcomes,” she said.
The First Steps and Beyond program is being funded in part by The Heinz Endowments, the Highmark Foundation and PNC.
“PNC is committed to promoting economic empowerment for all across our footprint,” Lou Cestello, PNC regional president for Pittsburgh, said in a statement. “We are proud to team up with them to improve health outcomes for underserved communities in our region.”