Reducing Infant Mortality Disparities in Wisconsin

1. Reducing Infant Mortality Disparities in Wisconsin Funded by: University of Wisconsin School of Medicine and Public Health Wisconsin Partnership Program

2. Infant Mortality Collaborative • Dottie-Kay Bowersox: Racine City Health Department • Murray L. Katcher MD, PhD: Wisconsin Division of Public Health • Stephanie A. Robert PhD: UW School of Social Work • Gloria E. Sarto MD PhD: UW Department of Obstetrics and Gynecology • Thomas Schlenker MD: Public Health of Madison and Dane County • Barbara L. Wolfe PhD: UW-Madison Department of Population Health Sciences

3. Goals and Objectives • Improve Wisconsin birth outcomes • Identify individual-level and contextual level risk/protective factors affecting birth outcomes and outcome disparities by race • Examine effects of public programs and policies on birth outcomes and birth outcome disparities by race • Understand impact of healthcare delivery system • Draw inferences about what brought about Dane County improvements • Disseminate findings to Racine and other communities

4. Methods • Examine trends in socioeconomic/racial composition and characteristics of population during this time using and linking existing data (Data committee) • Conduct Community Asset Mapping to examine potential risk/protective factors in neighborhoods (Community Asset Mapping Committee) • Engage African American community members in developing and implementing a structured survey to assess maternal attitudes and experiences before, during and after pregnancy (Survey Committee) • Examine birth records of African American and White mothers over this period of time (Clinical Records Committee) • Conduct similar tasks in both Dane and Racine Counties

5. In Progress • The Data Committee • Conducting analyses that include examinations of the causes of infant death: • Age of infants at death, abortion trends, influence of socioeconomic and other contextual factors, and risk factors for poor birth outcomes. • Survey Committee: • Survey has been developed, Community Research Associates trained (in both Dane and Racine Counties) • Over 600 surveys completed in Dane County (African American or white women who gave birth 2005-2007). • Dane county surveys will be completed early fall; Racine surveys will start in September.

6. Healthy Families, Healthy Communities Survey Developed in conjunction with national experts, local community women and our Community Advisory Board Health before pregnancy, health behaviors, social support, stress, sense of control, racial and age discrimination, use of medical and social services, perceptions of adequacy of services, perceptions of one’s neighborhood, residential history, maternal physical and mental health, financial situation, and demographic characteristics.

7. Progress cont… • Clinical Record Review Committee: • All African American births in Madison, Dane County, 1997 and 2007 have been collected and are being coded. • Similar clinical reviews in Racine have been initiated • Community Asset Mapping Committee • Compiled a list of resources, service providers and non-profit agencies providing support and health promotion services to women of childbearing age in both Dane and Racine Counties • Investigating similarities and gaps in services, also geographic distribution of assets to the community.

8. Progress cont…Community Asset Mapping The Neighborhood Deprivation Index: Calculates a measure of social and economic risk which uses U.S. Census data to consider income, education, employment, housing and household structure. This measure has been calculated for each block group in each county, and the committee is now mapping these findings, with spatial analysis looking at the overall measure of deprivation as well as the way these factors are concentrated or dispersed in each county still to come Anticipate analyses of clinical record reviews and survey will be available Fall, 2011. Data committee results will start becoming available Spring 2011

9. Community Advisory Board Betty Banks Brian Benford Mary E. Brown Thomasina Clay Carola A. Gaines Alex and Jackie Gee Dr. Perry Henderson Angela Jones Dr. Jack Kenny Pam Mcgranahan Merta Maaneb de Macedo Bobby Peterson Pamela Pfeffer John Powell Tom Schlenker Lucretia Sullivan Wade

10. Additional Colleagues Laura Berghahn MD Clinical Associate Professor Cheryl Braunreiter Director, Health Information Management – All Saints A. Michelle Booker Community Liaison Doris Franklin Public Health Madison Dane County Brendan Fulmer Medical Student Margaret Gesner Caldonia / Mt.Pleasant Health Department Erika Hagen U. W-Madison, Post Doc Teri Hicks Racine Public Health Dept Cheryl Mazmanian Western Racine County Health Department Pam McGranahan Public Health Madison Dane County Nonso Njokanma Mamadou Ndiye Public Health Madison Dane County Majiedah Pasha Project Administrator Angie Rohan Dept. of Health and Family Services Amanda Schmehil Resident Obgyn Julie Schuppie School of Social Work Sharyn Streicher RN Lucretia Sullivan-Wade Community Project Manager

11. “ Healthy Mothers make Healthy Babies; Healthy Babies make Healthy Families Healthy Families make Healthy Neighborhoods Healthy Neighborhoods make Healthy Communities” Surgeon General David Satcher