Initiative’s Work in Baltimore Neighborhood Leads to Drop in Infant Mortality

Baltimore’s Upton/​Druid Heights neigh­bor­hood saw a marked decline in infant mor­tal­i­ty over 10 years, the result of a mul­ti­part­ner city ini­tia­tive to keep babies and their par­ents safe and healthy.

The decline in infant mor­tal­i­ty in the neigh­bor­hood mir­rors that of a drop seen across Bal­ti­more fol­low­ing the 2009 launch of B’more for Healthy Babies — a col­lab­o­ra­tive effort led by the city’s health depart­ment, the Fam­i­ly League of Bal­ti­more and Health­Care Access Mary­land that includes more than 150 pub­lic and pri­vate part­ners that have worked to dri­ve down infant deaths and teen births in Bal­ti­more fol­low­ing years of poor out­comes and stag­ger­ing racial dis­par­i­ties.

Upton/​Druid Heights — a large­ly Black com­mu­ni­ty that has faced numer­ous chal­lenges because of the lega­cy of dis­crim­i­na­to­ry poli­cies and dis­in­vest­ment — had one of the high­est rates of infant death in Bal­ti­more (15 deaths per 1,000 births from 2005–2009). After 10 years of sus­tained invest­ment in the com­mu­ni­ty, the infant mor­tal­i­ty rate dropped by 75% to 3.8 deaths per 1,000 births from 2014–2018. The rate in Upton/​Druid Heights is now low­er than the nation­al rate (5.6 per 1,000 in 2019) and the State of Maryland’s (5.9 per 1,000 in 2019) and is com­pa­ra­ble to Bal­ti­more com­mu­ni­ties that are wealth­i­er and less neg­a­tive­ly affect­ed by the fac­tors that dri­ve poor health outcomes. 

“These results show­case how pub­lic and pri­vate enti­ties can effec­tive­ly work togeth­er to cre­ate pos­i­tive out­comes for fam­i­lies and chil­dren,” says Gena O’Keefe, a senior asso­ciate with the Annie E. Casey Foun­da­tion, which funds the ini­tia­tive along with numer­ous oth­er pub­lic and pri­vate part­ners, includ­ing long-time sup­port­er Care­First Blue­Cross BlueShield. ​“We invite oth­er com­mu­ni­ties to learn more about the suc­cess of this vital work and hope they view it as a mod­el to inform their programs.”

B’more for Healthy Babies’ inter­ven­tions and strate­gies have included:

• Cre­at­ing clos­er part­ner­ships between clin­ics, hos­pi­tals and com­mu­ni­ty orga­ni­za­tions that have led to greater access to health care for preg­nant moth­ers and babies through their first 18 months. This includes build­ing a cen­tral­ized intake sys­tem that con­nects young moth­ers to var­i­ous ser­vice providers.

• Launch­ing pub­lic edu­ca­tion cam­paigns, includ­ing those relat­ed to safe sleep for babies (advis­ing par­ents that infants should sleep alone and on their backs in a clean, cleared out crib) and those for young fathers that focus on how they can sup­port infant health along with mothers.

• Per­form­ing home vis­its to preg­nant moth­ers to check on their well-being.

• Host­ing sup­port groups for moth­ers — which include many who are between the ages of 14–24 — to talk about their chal­lenges and receive guid­ance about pre­na­tal care and post­par­tum sup­port. Dur­ing the COVID-19 pan­dem­ic, many of these meet­ings moved online.

“Our cel­e­bra­tion of the record low Black infant mor­tal­i­ty rate in Upton/​Druid Heights is a tes­ta­ment to the pow­er of col­lab­o­ra­tion and sus­tained com­mu­ni­ty invest­ment,” says Dr. Leti­tia Dzi­rasa, Baltimore’s health com­mis­sion­er. ​“B’more for Healthy Babies reminds us that pub­lic health inter­ven­tions work, and they can improve health out­comes for all of our communities.” 

Part­ner­ships, Fun­ders are Key to Improv­ing Outcomes

In Upton/​Druid Heights, Stacey Stephens, direc­tor of B’More for Healthy Babies at Promise Heights, says the close part­ner­ships between numer­ous orga­ni­za­tions, com­mu­ni­ty res­i­dents, faith-based groups and pub­lic enti­ties are dri­ving the improved results in the neigh­bor­hood. This includes col­lab­o­ra­tions with orga­ni­za­tions and busi­ness­es that do not offer health-care ser­vices — such as schools, bar­ber­shops, libraries and hous­ing com­plex­es that share edu­ca­tion­al infor­ma­tion about the initiative’s ser­vices and about infant and par­ent health in general.

Fun­ders are also impor­tant, Stephens says. Using a col­lec­tive impact approach, fun­ders have shown trust in the initiative’s lead­ers and allowed them to try new, inno­v­a­tive approach­es — includ­ing those that go beyond health care and assist moth­ers with their career, edu­ca­tion­al and life goals. ​“Com­mit­ted and flex­i­ble fun­ders have been impor­tant,” Stephens says. ​“Mov­ing for­ward, we know we must con­tin­ue find­ing fun­ders and part­ners with the same lev­el of pas­sion and com­mit­ment. We hope our results are noticed by oth­ers who can pro­vide support.”

Watch a webi­nar about efforts in three cities to dri­ve down infant mortality