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Poverty and Race's Impact on Infant Mortality in Memphis

This article explores the connection between poverty, race, and infant mortality rates in Memphis. It discusses various initiatives and programs aimed at addressing this issue and highlights the importance of social determinants of health.

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Poverty and Race's Impact on Infant Mortality in Memphis

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  1. Beyond Infant Mortality:What’s Poverty and Race Got To Do With It? Just about everything when it comes to staying healthy in Memphis. NNIP Spring 2010

  2. Phyllis G. Betts, DirectorContact pbetts@memphis.edu Center for Community Building and Neighborhood Action and InfoWorks Memphis School of Urban Affairs and Public Policy The University of Memphis

  3. Key Sources • Populations of Color in Tennessee: Health Status Report. Tennessee Department of Health Office of Policy, Planning, and Assessment and Office of Minority Health. Kenneth Robinson, et. al. 2007. • Center for Community Building and Neighborhood Action: analysis of birth and infant mortality and other indicators for Memphis and Shelby County. Ongoing.

  4. Infant Mortality Initiative • Commercial Appeal feature followed by Babyland • Shelby County Summit • TN Office for Children’s Coordinated Care • Infant Morality “Core Group” • Established Shelby County Office for Early Childhood and Youth • Early Success Coalition • Voices for Memphis’ Children

  5. Infant Mortality: Canary in the Coal Mine • 14 per 1000 2006 baseline • African American twice as high as white births • Drivers: Pre-maturity and low birth weight • 30% African American teens give birth by age 17 (city of Memphis) • NICU progress at The Med • Individual education and social support: Blues Project, Moses Model, Centering Pregnancy • Social Marketing w/ Community Voice • FIMR: Community Action Team

  6. Deaths Per 1000 Live Births, Top Ten Leading Causes of DeathShelby County, TN, 2006 Source: Death Certificate Data (Tennessee Resident Data),Tennessee Department of Health http://hit.state.tn.us/, accessed 5/11/2010

  7. Early Success Coalition • Nurse Family Partnership and support for building infrastructure (HHS) • LeBonheur (Methodist) Children’s Hospital and Shelby County Office for Early Childhood and Youth • 65 provider partners • Linked with Site Based Services Collaborative • Data Partners: CBANA-InfoWorks and UTHSC Preventive Medicine/CANDLE • National Mathematica evaluation • Collaborative planning and grantwriting • Advocacy: Voices for Memphis’ Children

  8. Getting Organized

  9. Early Success Focus Areas • Infant Mortality Initiative • Home Visitation • Parenting Support • Headstart-PreK-Child Care • Early Intervention • JustCare Family Network and JustCare 180 • Children’s Exposure to Violence • Community Risks and Assets: CBANA-InfoWorks • Policy Advocacy: Poverty as a Risk Factor

  10. Voices “Five Hopes” • Health • Behavioral Health • Education • Juvenile Justice • Social Equity: Unnatural Causes

  11. Poverty as a Risk Factor: Kids Heightened probability outcomes: • Infant mortality/prematurity/low birth weight and related diagnosis • Child obesity and diabetes • Lead poisoning/other heavy metal toxins • Asthma/other respiratory diagnosis (second hand smoke) • Nutrition-related developmental and cognitive diagnoses • Stimulation-related developmental shortfalls • Injuries from abuse, neglect, and neighborhood violence • Homicide

  12. Low Income 24% Dire Poverty 28% Below Poverty 15% Moderate and Higher Income 48% Child Poverty in Shelby County

  13. Reaching Families Where They Live

  14. Early Impact of Disparities Framework • Broaden focus to include Zone 2 • Asset Mapping • Transformation Institute: wrap-around system of care • Link with Site-Based Resident Services Collaborative: Reaching Families Where They Live • Toward a risk, assets, and segmentation model to drive action: Fragile Families framework

  15. The Bigger Picture:Social Determinants • Why are poverty and low educational attainment predictive of “unhealthy lifestyles”? • Hint: “ignorance” is an insufficient answer • Aggravating factor: hardship • Mediating factor: stress → depression • Mitigating factor: social support • Theory of change: stronger families in stronger communities • Confronting poverty

  16. Emerging Evidence: Stress • Cortisol, adrenalin, and inflammation • Biological markers vs. self-reports • Depression, self-medication, and immobilization vs. sense of efficacy and proactive self-care • Apparently self-destructive behavior is not just about poor self-esteem

  17. Primary Social Support Systems • Family • Neighborhood • Schools • Work • Housing as a Platform

  18. 1-Year Clinic Visit DataOutcome Measures

  19. 1-Year Clinic Visit DataOutcome Measures

  20. Reaching Families Where They Live: Peacemaking Circles at Autumn Ridge

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