Board proclaims September as Infant Mortality Awareness Month with focus on County services for Black and Indigenous communities

September 8, 2023

On Thursday, Sept. 7, the Board of County Commissioners proclaimed September 2023 as Infant Mortality Awareness Month in Multnomah County, recognizing County programs that educate the community, provide support and healthcare access for families, and ensure that babies thrive during their first year of life.

September also marks the National Infant Mortality Awareness Month, a campaign sponsored by the National Healthy Start Association focused on raising awareness of and eliminating disparities in birth outcomes in the United States.

Infant Mortality Awareness Month provides an opportunity for the community to get involved with programs working to reduce the infant mortality rate and provide support. It also serves as a time to encourage government agencies, community-based organizations, healthcare systems and academic institutions to work together to eliminate disparities and reduce overall infant mortality rates not just locally, but nationally.

Interim Health Department Deputy Director Chantell Reed told the board that a healthy baby starts with a healthy family. “If we give families healthy starts and the support they need, we know this will build healthy communities. The importance of raising awareness of infant mortality really builds on us being able to support where we go on the foundations of who we are as a community.” 

In Multnomah County, infant mortality and other adverse birth outcomes are lower compared to national rates, and have decreased over time. However, long-standing racial disparities persist among Black/African American and Native American/Indigenous communities.Disparities are greatest for Black/African American families and remain even when controlling for a mother’s income, prenatal care and education. Research links chronic stress related to racism as a key indicator of adverse birth outcomes, as studies have found Black/African American women with college degrees are more likely to have infants with low birthweight than white women who have not completed high school. 

Data for Multnomah County between 2019 and 2021 show that non-Hispanic Black/African American families experience the highest infant mortality rate among racial and ethnic groups at 9.2 per 1,000 live births: almost double the national rate and 3.2 times the rate for white infants in the county.

To improve birth outcomes, the Health Department and its partners are focused on expanding pregnancy and postpartum care to ensure that all people have affordable, easy access to birth and postpartum doula and lactation care. Services from the department’s Parent Child Family Health (PCFH) program support more than 7,000 women, infants and children each year.

PCFH provides home visits and other services that are responsive to the cultural needs of clients, promoting family bonding and parent-child attachment, improved pregnancy and birth outcomes, and the adoption of healthy behaviors during pregnancy and early life.

Another Health Department program, Healthy Birth Initiatives (commonly known as HBI), is dedicated to eliminating the disparities in maternal and infant mortality among Black/African American pregnant women and families through culturally specific home visiting services and community action.

The program provides culturally specific, Afrocentric services to Black and African American individuals and their families, including in-home case management, respite care, family planning, breastfeeding support, childbirth classes and more. 

HBI Program Specialist Desha Reed-Holden said that Black mothers and babies often do not have the protective factor of education and income, making it imperative that HBI serves all people, regardless of their income.

HBI Program Specialist Desha Reed-Holden, (right) Chaku Manaqi-Łush project coordinator Ashleigh Coon (center), and Interim Health Department Deputy Director Chantell Reed (left)

“A major gap in the offerings the County provides is not having adequate access to doula and lactation support,” said Reed-Holden. “We know that our families need that support around the clock in a way we cannot provide.” 

Through partnerships with other community organizations, HBI has been able to partner more parents with doulas, especially parents who are on Medicaid. However, access to doulas and lactation support for parents on private insurance remains a barrier. 

“Healthy Birth Initiatives is working to figure out what we can do to improve outcomes for all families,” said Reed-Holden. “If Black families have the widest disparities, we know that anything that benefits our community is going to benefit every community across the board.”

Other community partnerships include the Future Generations Collaborative (FGC), a community-based organization that serves the Indigenous community and provides resources and programs to generate a healthy, healing and growing Indigenous community. 

FGS’s roots trace back to 2011 when the Health Department convened American Indian/Alaskan Native community members, community-based organizations and public health agencies to promote healthy pregnancies in American Indian/Alaskan Native women in Multnomah County. 

American Indian/Alaskan Natives are more likely to have low birthweight and/or be born preterm when compared with non-Hispanic white babies. From 2019 to 2021, the low birthweight rate for American Indian/Alaskan Natives in Multnomah County was 6.3 per 1,000 live births, along with a preterm birth rate of 11.8 per 1,000 live births. That compares to a low birthweight rate of 5.9 births and a preterm birth rate of 7.9 per 1,000 live births among white non-Hispanic babies. 

For the past three years, PCFH has partnered with FGC to launch the Chaku Manaqi-Łush, or “Help Me Grow,” program, offering regular visits, groups and system advocacy in settings that are culturally nurturing, bringing in relationship-based, culturally attuned developmental programs and service providers.

Ashleigh Coon, the Chaku Manaqi-Łush project coordinator, said the program creates a comfortable environment where families can access play groups, parenting circles, one-on-one family support and other services that connect families to the healthcare system and support families’ mental, physical, spiritual and emotional health. 

“As Native people, we are proud, respective, resilient and strong,” Coon said. “We draw strength from our traditional practices and value those in our community as relatives. To support these values and cherished ties, we offer a holistic approach where we prioritize family wellbeing through the relationship of connection and collaboration.”

FGC currently is working with community partners such as the Native American Youth and Family Center, the County’s Women, Infants and Children program, and Multnomah County Libraries to build successful circles of care for families, educate the community on health disparities and eliminate the core drivers of those disparities.

“Cultural programming is a must,” Coon said.

Commissioners thanked the providers and highlighted the need to focus services on communities facing disparities in healthcare outcomes.

Commissioner Lori Stegmann called attention to the importance of having culturally specific programming for Indigenous and Black communities. “I look forward to seeing how we can make bigger leaps in giving folks the services they need to make sure all our youth can live past their first year.”

“As a mom and a healthcare provider, I’m very passionate about this issue and have been aware of and horrified to see the deep disparities for Black and Indigenous mothers,” Commissioner Sharon Meieran said. “Those statistics represent people.”

“The fact that the wealthiest country in the world has low birth rates that are on par with the whole rest of the world is an indicator of how poorly we are doing as a country,” Commissioner Susheela Jayapal said. “This shows the importance, effectiveness and need of traditional practices.”

“I can’t imagine the heartache that comes with not being able to celebrate your child’s first birthday, which, as a mom of three, that to me would be the ultimate heartbreak,” Commissioner Julia Brim-Edwards said. “I love seeing the proactive, tangible things, such as the doulas and lactation consultants, that we can do to change those bad outcomes”

“Whether you’re a parent or not, infant mortality touches and impacts all of us,” said Chair Jessica Vega Pederson. “Investing in the health and wellbeing of pregnant people leads to healthier infant outcomes, including increasing birth weight and reducing risk of preterm delivery.”