Approaches could reduce Kansas infant mortality disparities
Amina Seck
Feb. 12, 2019
A recent Kansas Action for Children brief highlights the high rate of infant mortality among Black Kansas babies. Black Kansas babies are three times more likely to die before their first birthday than white babies. The high infant mortality rate among Black babies is linked to a variety of factors, including racial discrimination.
KANSAS INFANT MORTALITY RATES DIFFER BY RACE DUE TO STRESS AND OTHER FACTORS
Source: Annual Summary of Vital Statistics, Kansas Department of Health and Environment. Five Year Combined Infant Mortality per 200 2017 Live Births
Medical professionals and community members in Kansas are working together to identify areas for improvement, innovation, and collaborative learning to reduce infant mortality and improve birth outcomes. Kansas professionals and community members are primarily using two approaches to reduce high infant mortality rates: 1) cultural competency trainings and 2) home visiting programs.
Cultural competency
Cultural competency is the ability of health care providers and organizations to provide successful services that meet the social, cultural, and linguistic needs of patients.[1] A lack of cultural competency can result in patients feeling uncomfortable, which can reduce their willingness to access services.[2] However, educating doctors and other medical staff about implicit bias can help mitigate its negative effect.
Cultural competency training gives healthcare providers strategies to counter implicit bias, which can increase communication between medical staff and patients. This, in turn, can reduce stress in mothers-to-be of color, thereby improving the health of mothers and infants.[3]
In 2008, the REACH Foundation initiated the Kansas City Cultural Competency Initiative (KCCCI). More than 20 organizations in Kansas participate in the program. KCCCI prepares organizations and their staff to meet the health needs of racially, ethnically and cultural diverse populations. KCCCI has a focus on community learning and cultural competency planning and implementation.
The learning community has a monthly meeting, bringing diverse groups together to address different social topics such as the inequality in the health care system, implicit and explicit bias, poverty, transracial foster care and other issues.
Home visits
One of the primary causes of infant mortality is Sudden Infant Death Syndrome (SIDS). In 2016, more than one-in-five cases of infant mortality were due to SIDS.[4]
To reduce SIDS, it is important for infants to have a safe sleeping environment. Home visiting programs teach parents about safe sleeping environments and child development. In addition, they provide an opportunity to answer parents’ questions in an informal setting. In the absence of feeling comfortable in medical settings, new mothers (especially mothers of color) might feel more comfortable having home visits.
There are six different home visiting programs in Kansas, four of which are available statewide. These programs are free and voluntary, but families must be eligible for the programs (through income level or disability). The programs provide supports for families and children from pregnancy until entering kindergarten. Early Head Start, Parents as Teachers, Healthy Families, and Infant Toddler Services are available statewide. TIES in Wyandotte County and the Nurse-Family Partnership Shawnee County are only available in these counties.
Reducing the high infant mortality rate, particularly for Black babies, is a community effort. Professionals, service providers, and community leaders need to work together to make changes. Cultural competency and home visits are two approaches being used in Kansas to reduce high infant mortality rates among Black babies.
Legislators can build on the work being done at the local level to reduce high rates of infant mortality among Black babies by expanding KanCare, ensuring newborns are automatically enrolled in health coverage, and adopting paid parental leave.
[1] Betancourt, J. R., Green, A. R., & Carrillo, J. E. 2002. Cultural competence in health care: Emerging frameworks and practical approaches. New York: The Commonwealth Fund.
[2] Prather, Erin. “Understanding Your Patients: Cultural Competency Can Make the Difference.” TexasMedicine. March 2006.
[3] Chuck, Elizabeth. “How training doctors in implicit bias could save the lives of black mothers.” NBC News. May 2018.
[4] Soap, Julia. “Infant Mortality 2016, research Brief.” Kansas Department of Health and Environment. Sept. 2017
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