The Multnomah County Board of Commissioners on Thursday proclaimed September Infant Mortality Awareness Month in Multnomah County, "in recognition and celebration of the importance of each child born in our community celebrating their first birthday and living healthy and rewarding lives.”
National Infant Mortality Awareness Month provides an opportunity to recognize the work and partnerships that support healthy families. In Multnomah County, those programs include Parent Child Family Health, the Healthy Birth Initiative (HBI) and the Future Generations Collaborative, and many others. It’s also a chance to encourage governments, community-based organizations, healthcare systems and academic institutions to work towards eliminating infant death..
“It’s important for us to recognize Day 366 because every child deserves to reach this milestone to have a healthy start to reach their lifelong potential,” said LaRisha Baker, Maternity Child Family Health Director and deputy director of the Public Health Division.
Nationally, the United States’ Infant mortality rate is 5.6 percent, higher than many other industrialized nations. Those rates are highest for Black and African American infants, followed by Native and Pacific Islander infants. Those differences are rooted in the systemic racism and intergenerational stress experienced by parents who have historically had less access to healthcare, income, housing and safe neighborhoods than White parents.
Those trends— and the disparities — have played out locally; in 2018, the most recent year for which data was available, the infant mortality rate for Black infants was 10.5 percent, compared to 3.7 percent for white infants and 4 percent overall.
“It’s absolutely unacceptable the infant mortality rates this country experiences,” said Commissioner Lori Stegmann. “It does tell me we are on the right track, when this board declared racism as a public health crisis.”
Social and health services can change that narrative; for infants whose parents take part in the Healthy Birth Initiative and Nurse Family Partnership, the mortality rate was just under 4 percent.
“This relates to whether there are strong healthy social systems and conditions in place,” Baker said. It’s a reflection of social determinants of health: equity, poverty and access to quality and unbiased healthcare. We know early childhood development, positive experiences and programs such as HBI are essential to address infant mortality.”
Those services have been challenged over the past 18 months as COVID-19 forced providers to shift to virtual engagement, all while staff struggled to cope with the pandemic in their own lives.
“This last year and half have been especially challenging for staff,” Baker said. “I want to extend my gratitude and thank our staff for their tireless work and for continuing to respond to our communities while living through COVID themselves. They have done an outstanding job.”
“I so appreciate the partnership between HBI and Nurse Family Partnership,” Commissioner Susheela Jayapal said. She asked Baker how the program has maintained relationships with families through COVID-19.
The program, like so many, had to stop home visits, and instead transition to phone and video connections, although “we really encouraged more video conferencing,” Baker said. To address families struggling with the economic impact of the pandemic, HBI partnered with the county’s Emergency Operation Center to deliver food boxes and worked with the Portland Diaper Bank to deliver diapers.
If such a thing as a silver lining can be found in the COVID-19 pandemic, it has been an opportunity to expand community partnerships, wraparound social services and financial support to families, and to work with large health systems to address the systemic racism in healthcare that contributed to infant deaths.
The Healthy Birth Initiative serves Black pregnant families by offering case management through Nurse Family Partnership, prenatal and childbirth education, case management for male partners and resources for new parents and babies through age 2, said Desha Reed-Holden, a program specialist.
“Most importantly for HBI, our services are open to families regardless of income, because we know the disparities Black parents face in regards to mortality and morbidity are not related to income,” Reed-Holden said. “And so we serve all Black families in Multnomah County.”
Such Partnerships are paying off. Providence Health system for instance, has begun offering scholarships to train doulas who are Black, Indigenous, or other people of color. The Black Parent Initiative provides culturally-specific doula support and parenting and lactation support.
Other community partnerships expand support for health births, and include a focus on American Indian and Alaska Native families.
Suzie Kuerschner, with the Future Generations Collaborative, described the program that seeks to promote healthy pregnancies and cultural healing in the Native American community through culturally-responsive and community-centered programming and advocacy.
“Life is sacred. We seek to invite it, nurture it and celebrate it,” Kuerschner said. “We recognize that as a result of hospital trauma, boarding schools, a lot of factors, substance use entered our communities and our families and created incidents and prevalence of Fetal Alcohol Syndrome disorder.’’
The Collaborative I is based on the belief that culture is protection. Among its programs are traditional story times, parent-child support circles, infant groups and weekly gatherings. One project named Chaku Manqi Lush, or “Help me Grow,” is an outdoor playscape that, during the pandemic, has allowed for a COVID-responsive classroom. It’s been a hub of providers and families coming together for referral and sharing information.
“We are blessed as Indigenous people to have the traditions, values, and knowledge our ancestors brought forth,” she said.
The Board applauded the service providers.
“I really just appreciate the presentation and the proclamation to give awareness to all the great work that’s happening,” said Commissioner Jessica Vega Pederson.
Services for parents and children
Women infants and Children: WIC provides healthy foods, nutrition education and breastfeeding support to low-income families in Multnomah County. People might qualify for WIC if they are pregnant, a new parent, or if they have a baby or young children under 5 years old.
Maternal, Child and Family Health Services: Maternal, Child and Family Health Services program provides a range of services to help support people who are pregnant or parenting young children.
Healthy Birth Initiative: Afrocentric support to pregnant African American people and their families before and after birth.Future Generations Collaboration: a coalition of American Indian and Alaska Native community members, Native-serving organizations, and government agencies that work to increase healthy pregnancies and strengthen families in American Indian and Alaska Native communities.