Community-Based Health Program Reduces Infant Mortality Rates

A community-based health program at The Ohio State University Wexner Medical Center targeting both expectant and new mothers has significantly reduced infant mortality rates, according to a new study published in The Journal of Maternal and Child Health.

The program, Moms2B, integrates education, services, and support directly in affected neighborhoods.

New research indicates that women who attend at least two Moms2B sessions may have lower rates of preterm birth, low birth weight, and infant mortality in comparison to women who only received individual care.

"When we started the program 10 years ago, the infant mortality rate was as high as 19 per 1,000 births in some of these neighborhoods. Now it's down to 10 per 1,000," said Patricia Gabbe, MD, founder and director of the Moms2B program and pediatrician at the Ohio State Wexner Medical Center. "This kind of success has never happened before and wouldn't be possible without our community collaborations."

More than 22,000 babies die before their first birthday annually in the US. Racial health disparities skew this statistic, with an infant mortality rate for Black babies that is twice as high compared to White babies. Experts say many of these deaths are preventable by ensuring access to care for expectant mothers and empowering them to deliver healthy babies.

To ensure the program would address health disparities in the most beneficial way possible, Gabbe and the Moms2B team talked directly with expectant mothers on the social determinants of health they face.

"For too long, we've relied on obstetricians and pediatricians to tackle this public health problem, and it hasn't worked. So instead, we went into these at-risk neighborhoods and talked to women about the challenges they face, what they want to learn, and the services they need," said Gabbe.

"We learned that things like housing, food insecurity, and childcare are huge barriers for these women, and it was a big help when deciding where to concentrate our efforts,” Gabbe continued.

Moms2B is a growing program, providing more than 2,500 women with social and medical services, information on pregnancy and parenting, and healthy meals at every session.

"The most important thing I've learned is the importance of keeping your stress down when you're pregnant," said Monyia Wilson, Moms2B participant and mother of five. "Throughout my pregnancy, having support like Moms2B makes you feel like things aren't that hard because they're right there with you. It makes me want to keep coming back and helped me have healthy pregnancies."

The Moms2B team is made up of doctors, nurses, dietitians, lactation counselors, navigators, community health workers, social workers, and health care students.

"Not only are we able to teach moms through this program, but the moms also teach us about the barriers this population faces," Gabbe said. "If health care professionals are more informed about the obstacles expectant mothers need to overcome, we can better help them have healthy pregnancies and babies."

Gabbe and her team are working with partners across the country to expand the successful program to more cities and neighborhoods.

In addition to worse infant mortality rates, Black people have higher maternal mortality rates (MMRs) as well. In a letter responding to a CMS request for information, the American Academy of Family Physicians (AAFP) noted that MMRs are four to five times higher for non-Hispanic Black women compared to white women, according to research from the Centers for Disease Control & Prevention.

“The AAFP recognizes that these unequal outcomes are the consequence of decades of structural and systemwide inequities designed to deliver unequal and disparate care for women of color based on institutionalized racism and the unconscious biases of health care providers toward women of color,” the letter said.