Wisconsin Panel Presentation Region V Infant Mortality Summit, Chicago, IL March 21, 2013 Linda Hale, RN, BSN, EMT Title V Maternal and Child Health Director Wisconsin Department of Health Services
Background – Wisconsin • Wisconsin has the highest black-white infant mortality disparity in Region V. • African American infants (2010): • 10% of births • 24% of deaths http://www.dhs.wisconsin.gov/publications/P0/p00144-2012.pdf • Dr. Michael Lu introduced the life-course approach to the state in 2003. • By 2004, the Title V MCH program had taken a leadership role, and the issue was a departmental priority. http://journals.lww.com/jphmp/Fulltext/2008/11001/Wisconsin_Healthy_Birth_Outcomes__Minority_Health.11.aspx
Key Activities – Wisconsin • Statewide Advisory Committee on Eliminating Racial and Ethnic Disparities in Birth Outcomes, including partnerships and website (2006-present).http://dhs.wisconsin.gov/healthybirths • UW School of Medicine and Public Health $10 million Lifecourse Initiative for Healthy Families (LIHF); PRAMS to track impact (2009 - present).http://www.med.wisc.edu/wisconsin-partnership-program/lifecourse-initiative-for-healthy-families/502 • Partnership with Medicaid on Medical Home Pilot in Southeastern Wisconsin (2009 - present).http://www.dhs.wisconsin.gov/rfp/DHCF/pdf/Southeast%20Wisconsin%20Medicaid%20Managed%20Care%20Organizations%20RFP.pdf • Wisconsin Healthiest Women Initiative (2011 - present).http://www.dhs.wisconsin.gov/healthybirths/advisory20110908.htm and http://www.amchp.org/programsandtopics/BestPractices/InnovationStation/ISDocs/Womens-Health-Now-and-Beyond.pdf • Title V funds focused on systems development, including local review of infant deaths (2011- present).http://www.dhs.wisconsin.gov/health/mch/EarlyChildhoodSystems/KKAdefinitions.htm and http://www.chawisconsin.org/kka.htm
Successes – Wisconsin • Comprehensive home visiting program at City of Milwaukee Health Department, 2005-present (73% of the state’s African American deaths are in Milwaukee). http://city.milwaukee.gov/Empowering-Families-of-Milwaukee.htm and http://dcf.wisconsin.gov/children/home_visiting_needs_assessment/default.htm • Stress identified as key in poor birth outcomes through ABCs for Healthy Families and Journey of a Lifetime Social Marketing Campaign to Integrate Life-Course Perspective (HRSA First Time Motherhood/New Parents Initiative Grant) 2008-2010.http://www.dhs.wisconsin.gov/healthybirths/abcsfamilies.htm • Partnership to Eliminate Disparities in Infant Mortality addressing racism and importance of fathers (Kellogg-sponsored 2008-2010)—partnership is ongoing. . http://www.amchp.org/programsandtopics/womens-health/infant-mortality/Documents/TakingFirstStepBooklet.pdf • Life course trainings and technical assistance to partners and local health departments. http://link.springer.com/article/10.1007%2Fs10995-013-1225-x and http://www.dhs.wisconsin.gov/health/mch/EarlyChildhoodSystems/core-competency/1b.htm
Challenges – Wisconsin • Taking interventions to scale. • Longstanding socioeconomic and environmental factors. • Sustained community involvement.
Wish List – Wisconsin • Collaborate with other states in Region V for a common approach and supportive network. • Share data, successes, and ongoing challenges. • Identify best practices for reducing disparities in infant mortality.