Madison, Wisconsin - Black women and men in Dane County identify persistent, unchanging racial and economic inequity as key drivers of the disparity in infant birthweights and birth outcomes in the county.
That is one key finding of a new report: "Saving our Babies: Low Birthweight Engagement." The Dane County Health Council and the Foundation for Black Women's Wellness released the report on African-American infant health in Dane County today in honor of Black Maternal Health Week.
After a nine-month public engagement effort commissioned by the Health Council and led by the Foundation and its project partner EQT By Design, LLC, the report found that African-Americans in Dane County identify the following as root causes of low-birthweight Black infants: stressed Black family systems; generational struggles for economic security and stability; and institutional racism and bias and their impact on Black life and progress. Babies born to African-American mothers in Dane County are two times more likely than White infants to be born with low birthweights, a factor which puts the infants at risk of significant health challenges and higher mortality rates. Recent Public Health Madison & Dane County data show Black infant mortality rates as high as 12.0 infant deaths per 1,000 live births during 2016-2018. Wisconsin ranks worst in the nation for Black infant mortality.
The report was not designed as a rigorous research study, but instead focused on a series of community conversations, surveys and facilitated discussions with nearly 300 participants including over 200 Black women, as well as Black men, health-care professionals and social services providers who serve Black women and families.
"What we heard definitively from Black women and men is that the poor birth outcomes experienced by many Black families are, in their eyes, driven by larger social and economic forces that exert pressure and persistent stress on their lives as individuals and family units," said Lisa Peyton-Caire, Founder and President of the Foundation for Black Women's Wellness. "The last nine months of work has been unprecedented in that we were able to engage so many voices. Our charge now is to work in partnership to implement solutions that will secure the long-term health of Black babies in Dane County. This must include intentional steps to improve the well-being of Black families."
The report identifies 10 consistent themes that emerged from the engagement effort that drew from African American residents from across Dane County:
Racism, discrimination and institutional bias
Bias and cultural disconnect in health-care delivery experiences
Housing insecurity and high cost of living
Poor access to health-supporting assets
Inadequate social supports
Gaps in health literacy, education and support
Disconnected and hard-to-navigate community resources
Systemic barriers to individual and family advancement
"These findings align with hundreds of studies that detail how toxic stress and racism throughout the lives of individuals of color impact their well-being. We must focus on the wide-ranging factors that are driving these inequitable birth outcomes. We know these outcomes are not inevitable and can be undone. Working in partnership, we can interrupt this cycle," said Janel Heinrich, director of Public Health Madison & Dane County.
"This report's goal was to gather insight, perspective and feedback from those most significantly and directly affected by this issue: Dane County's African-American community," said Dr. Ken Loving, Access Community Health Centers CEO. "This summary is a powerful first step as we move forward in collaboration toward saving our babies."
The report also proposed several community-informed next steps and solutions that include:
Internal health-system actions such as expanding promising initiatives like the Centering Pregnancy (group prenatal care) program.
Community investments such as expanding the pool and presence of African-American doulas and improving teen sexual and reproductive health education.
System and policy action such as expanding affordable housing, child care and tying health care to economic and regional advancement.
A press conference outlining specific next steps is expected in July. The full report can be found at www.ffbww.org/savingourbabies.
The Dane County Health Council members include: Access Community Health Centers, Group Health Cooperative of South Central Wisconsin, Madison Metropolitan School District, Public Health Madison & Dane County, SSM Health, United Way of Dane County, UnityPoint Health-Meriter and UW Health.
Black Maternal Health week is April 11-17.