Despite gaps between white and African-American infant mortality rates, Wisconsin is utilizing health equity principles to eliminate the disparity, and has already achieved results.
Through critical partnerships with health care providers and health agencies, the Wisconsin Department of Health Service (WDHS) embarked on an ambitious program to provide better health and prenatal care to African-American women.
"Initially the big challenge was awareness and acceptance," says Patrice M. Onheiber, director of the state’s Disparities in Birth Outcomes within the Bureau of Community Health Promotion. "We pride ourselves on being progressive and having healthy families. We wanted people to understand it, accept it and not turn away from it."
African Americans make up about 6 percent of the Wisconsin population, and nearly 90 percent of the African-American population lives in three counties located in the southeastern part of the state with the four communities with the highest rates, Milwaukee, Beloit, Racine and Kenosha.
Wisconsin launched an intensive review of the state’s infant mortality initiatives and developed partnerships with groups in local communities where rates were high. One of the critical new initiatives was the state’s partnership with the University of Wisconsin School of Medicine and Public Health. The University launched an innovative $10 million program, the Lifecourse Initiative for Healthy Families, to identify and address the needs of African-American women and families.
Wisconsin health officials see their work with the African-American community as integral to the state’s overall efforts to improve health outcomes in the entire population. "It’s hard to overstate how obvious it is that the overall health of a state really depends on trying to ensure that all of its residents are as healthy as possible," said Karl Pearson, Research Analyst at WDHS.
The WDHS interventions included establishing a medical home for mothers with high-risk pregnancies, a comprehensive home visiting program in Milwaukee, focus groups and outreach programs for African-American moms, developing anti-stress and smoking-cession campaigns for mothers.
"It is not just getting women into early prenatal care," says Onheiber, noting that the African-American infant mortality rate is still at 14.3 compared to the state’s rate of 6.0. "We needed to better understand the social and economic factors. This is not easy and it’s not quick. We’re in for the long haul."