First Steps and Beyond Aims to Reduce Black Infant Mortality

Despite advanced resources, infant mortality rates are rising. The First Steps and Beyond initiative, prompted by a 2015 University of Pittsburgh study, targets health disparities in the city, particularly the alarming death rates among Black babies. Highmark Health and Allegheny Health Network (AHN) have partnered to tackle this issue, with the ultimate goal of ensuring every Black baby reaches their first birthday.

The director of First Steps and Beyond at Enterprise Equitable Health Institute Takiyah Durham, MBA, and senior vice president and chief diversity officer of Highmark Health/AHN, Margaret Larkins-Pettigrew, MD, professor and academic chair of obstetrics and gynecology at Drexel University College of Medicine, discuss the program’s objective to reduce these rates through community collaboration, focusing on preterm births, racial disparities, safe sleep practices, and trimester support.

Transcript:

What was the motivation behind the initiation of First Steps and Beyond?

Takiyah Durham, MBA: So, if we kind of put things into perspective, we know that the United States has one of the highest rates when it comes to maternal mortality and infant mortality. Despite having the most resources via one of the most technologically advanced nations, our infant mortality rates continue to rise.

When we think about that, it helps me to go back to the mortality review committee's findings. So, we look across the country; 2 out of 3 pregnancy-related deaths are preventable. So we think about those stats. If 2 of 3 pregnancy-related deaths are preventable, we think about if we had the right systems in place, the right resources in place, being one of the most advanced nations in the world, how we could really impact infant mortality.

And if we drill down to Pittsburgh, to Allegheny County, and we look at our statistics, Black babies in Allegheny County are 2 to 3 times more likely to die before their first birthday. So, we put those things into perspective and we think about the risk factors from social determinants of health disparity component, and we group that into who it impacts the most. It goes back to Black babies and Black birthing people. And so with First Steps and Beyond, we want to ensure that every Black baby celebrates his first birthday.

In order to do that, it requires an all-hands-on-deck approach, a community approach, and what we've formed is a community collaborative. We are focused on Black maternal and infant mortality in Allegheny County because of the rates and who it impacts. What we would love to do is make sure every baby makes it to their first birthday and beyond, and also help to impact those mortality rates.

Some of our focuses, or our goals, would be the preterm birth rates, the racial inequalities, the safe sleep, and also 4 trimester support. Those areas that are most impacted by infant mortality and maternal disparities. And we'll get into that, hopefully today.

Margaret Larkins-Pettigrew, MD: So, I just wanted to add a little bit to that only because when we talk about why here–and Takiyah already mentioned the fact that in Allegheny County, we want to make a difference–is we know that if we make some significant efforts as it relates to implementing interventions that effect and decrease the death of Black babies, that we decrease the death of all babies, which is why she said we need to decrease the death of all babies.

That number should be zero. As it turns to maternal health and neonatal health or death of babies, that number should be zero in our country, because most of the deaths are because of preventable causes.

And then the whole issue of why here in Pittsburgh, Dr. Miller and her crew at the University of Pittsburgh did a study back in 2015, I believe it's older now. And based on that study, she identified multiple areas within our city alone, that have large gaps in health disparities. Not only incorporating what happens in the social determinants of health area, but also that big gap that includes not only, cardiovascular disease, cancers, incarcerations of young African American and other Black populations, but one of the ones that really rose to the top, of course, was the death of Black babies.

And that's why Highmark (Health) and AHN decided, if we start anywhere, let's start here. And if we can make a difference here then we can do some things in some other areas of health disparities.