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12 community leaders commit to fighting Milwaukee's crisis of infant deaths

 

Dec. 17, 2011 |(33) Comments

 

As part of our Empty Cradles project, Journal Sentinel reporters asked a dozen community leaders two questions:

 

 What is the most important thing we must do to confront Milwaukee's infant mortality crisis?

 

 What is your commitment to making a difference in the year ahead?

 

Here are excerpts from their responses:

 

Patricia McManus, executive director and CEO, Black Health Coalition of Wisconsin

 

Most important: The next thing that must be done is a commitment by the City of Milwaukee, the Greater Milwaukee Committee, the Metropolitan Milwaukee Association of Commerce and other political leaders to the revitalization of the central city, specifically economic development, which reduces the high unemployment among African-American males. To focus only on health care and the reduction of risk behaviors does not get at the heart of the problem.

 

Commitment: We are going to collaborate with other agencies who are interested in getting African-American fathers more education and jobs. We also plan to be more vocal in the dialogue about what is important for this community to have better survival rates. The Milwaukee Healthy Beginnings Project will attempt to get more funding to expand our coverage of at-risk families.

 

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Mayor Tom Barrett

 

Most important: The root causes of infant mortality and poor birth outcomes - including poverty, joblessness, poor education, stress and lack of access to good health care - affect every resident of this region, no matter where you live. We must continue to raise awareness . . . and turn that awareness into action.

 

Commitment: In addition to having the city take the lead role in applying for an innovative federal grant to support our (home visitation program), I will be reaching out to stakeholders to ask for their financial commitment to increase the reach of this program, as well as our Cribs for Kids program.

 

For the first time, we have set a specific infant mortality goal. We will decrease the infant mortality rate for African-Americans 15% by 2017 and the overall rate by 10%. I set this ambitious, yet achievable, goal to provide us with a benchmark of progress toward the ultimate objective - to bring our infant mortality rate in line with the national average.

 

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Robert N. Golden, dean, University of Wisconsin School of Medicine and Public Health

 

Most important: There is a moral imperative to apply evidence-based approaches as quickly as possible. This includes education outreach efforts, targeted at those with the greatest risk, that explain what we know about the risk factors and ways to diminish them. . . . At the same time, we must accelerate our research efforts to better understand the genesis of the problem and to create better prevention and treatment strategies.

 

Commitment: Through our Wisconsin Partnership Program, the UW School of Medicine and Public Health is committed to providing $10 million in support over the next several years (through the Lifecourse Initiative for Healthy Families) to community organizations that develop and then implement local comprehensive programs for addressing this issue. We will also provide expertise and consultation to those programs via our faculty and staff who are experienced in implementation strategies at the community level.

 

We are also planning to recruit a national expert in this area who can provide long-term, sustained leadership in our efforts to create permanent partnerships between our school and the local communities.

 

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Dennis G. Smith, secretary, Wisconsin Department of Health Services

 

Most important: There are three key parts in the health care system - access to appropriate prenatal care; healthy lifestyle; and, in the event of high-risk pregnancies, access to the technological advances of medicine. We need to continue raising awareness of the actions all pregnant women need to take to ensure a healthy pregnancy, such as good nutrition and pursuing a healthy lifestyle that does not include smoking.

 

Commitment: One department effort that will address the level of prenatal care services women get is the "medical home" pilot for high-risk pregnancies within the Healthy Birth Outcomes initiative. Managed care organizations in southeast Wisconsin collaborate with 16 clinics that provide more than 600 women (receiving Medicaid coverage) with obstetrics and primary care services, increased care coordination, home and community visits and improved access to providers.

 

The department will be expanding the successful medical home model to reach more pregnant women - those who receive fee-for-service Medicaid and are not enrolled in an HMO.

 

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Tina Mason, program director of OB/GYN residency, Aurora Sinai Medical Center

 

Most important: We must support the ongoing work of organizations such as the Wisconsin Partnership Program. We want to bring new ideas to successful existing programs to build on these efforts instead of re-creating work that has already been done. An example would be Aurora Family Services' new Healthy Families Milwaukee program, where a caregiver helps coordinate care in the home, as well as in the medical facility.

 

Commitment: Aurora Health Care operates more than a dozen programs that help mothers with high-risk pregnancies have positive outcomes. Today, we are piloting a Medicaid HMO "medical homes" for high-risk pregnancy program that we designed using medical best practices to help pregnant women receive the prenatal care they need.

 

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Tim Sheehy, president, Metropolitan Milwaukee Association of Commerce

 

Most important: Support the efforts of the mayor, the United Way of Greater Milwaukee and other organizations that are bringing awareness and focus to this devastating community issue. I hope a sustained effort will build the necessary understanding with parents and young adults of the significant responsibility needed at all times to raise a child.

 

Commitment: If we don't have a thriving economy, we won't have the resources to support these needed community programs. . . . Most of the $46 million raised by United Way comes from our members. . . . If this is a priority for the community, my answer would be you request more resources from that, or make a special appeal for us to respond to.

 

The conversation in the business community is most sharply focused on K-12 education. I haven't had a conversation with anyone in the business community about infant mortality. They're not looking at the landscape of social service programs and issues. They're most closely connected to getting folks a high school degree so they're trained in skills that are needed.

 

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Nicole Angresano, vice president of community impact, United Way of Greater Milwaukee

 

Most important: Collaborate and coordinate. There are so many strong efforts underway in this community - it's imperative that we work together to identify what is working, expand successful strategies to areas that are underserved, and make sure that our dollars are being invested strategically rather than emotionally.

 

Commitment: United Way of Greater Milwaukee has made reducing infant mortality a priority in 2011 and beyond by establishing the Healthy Birth Initiative: Reducing Infant Mortality, a strategy similar to our successful teen pregnancy prevention model. Through the initiative, United Way is committed to: raising awareness about the issue by revealing how racial and ethnic birth outcome disparities affect all sectors of society, identifying and funding evidence-based programs that will impact the root causes and result in positive birth outcomes and measuring the collective impact of funded programs.

 

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Veronica Gunn, medical director of Community Services, Children's Hospital and Health System

 

Most important: Reducing infant mortality in Milwaukee will require a coordinated, collaborative effort among public and private entities at individual, family, community, city and county levels. Efforts should be data-driven and focused on modifiable, measurable factors. Collaborative partners should agree on common goals and metrics of "success" and can align efforts in a complementary way.

 

Commitment: The Children's Health Alliance is coordinating the statewide efforts to build a comprehensive child death review program. The CDR program builds multidisciplinary review teams at the local level that seek to identify the risk factors and circumstances surrounding an infant or child death.

 

Children's Community Health Plan offers the "medical home" pilot program for pregnant women. . . . CCHP also has partnered with the Wisconsin Association for Perinatal Care to develop an interconception follow-up program, and is creating a baby book with an interconception message that will be distributed to all CCHP members who have recently had a baby.

 

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Philip Farrell, neonatologist and former dean of the UW School of Medicine and Public Health and co-chair of the regional Lifecourse Initiative for Healthy Families

 

Most important: The first essential step to "tackle infant mortality" is to understand it thoroughly and then to plan for long-term, community-based, sound intervention projects that are well-led and funded. . . . At least 10 and probably more years will be needed to eliminate the disparity, along with a Lifecourse strategy that addresses root causes comprehensively and ensures better health, prenatal care, housing, education, economic support, etc. And, unfortunately, racism is one of the causes and must be eliminated.

 

Commitment: I am deeply committed to the two-phase program we have launched with the following "cornerstone goals" now well underway: building community relationships in Milwaukee, Racine, Kenosha and Beloit and creating partnerships; raising public awareness to increase political support, understanding, motivation and funding; analyzing /planning as a key element of Phase I that has led to four impressive "Community Action Plans" that can be activated during 2012 and sustained long term; and implementing evidence-based interventions in the four communities.

 

In essence, just as a successful house construction project requires investment in a good foundation and framework, LIHF has made the critical community investments during Phase I that should pay dividends during the marathon ahead. Now, we are eager to proceed with Phase II and increase the collaborative action applied to Wisconsin's greatest challenge.

 

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Bevan Baker, health commissioner, City of Milwaukee

 

Most important: Everyone who cares about this issue must come to the table. Everyone who works on this issue must coordinate their efforts.

 

Commitment: To work toward the mayor's 2017 infant mortality reduction goal. By taking the brave step to set a specific goal for addressing a complicated, difficult problem, we are promising to hold ourselves accountable for our progress. The Health Department has a significant role to play in achieving the goal through continuation and expansion of successful programs (such as our intensive home visitation programs and our Cribs for Kids program) - but as we've said many times, we cannot do it alone.

 

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Dalvery Blackwell, co-founder, African American Breastfeeding Network of Milwaukee

 

Most important: Endorse the world gold standard for normal pregnancy, birth and infant feeding: certified nurse midwifery care and breast-feeding. Every pregnant mom should be under the care of a midwife, and we should assume that breast milk is her choice of nutrition for her baby. National data from several sources support the positive outcomes of both breast-feeding and certified nurse-midwifery care.

 

Commitment: We will host monthly breast-feeding community gatherings to bring lactation experts together with mothers and their families to discuss concerns, dispel myths and learn ways to have breast-feeding success. Also, we will work with community partners to support and train breast-feeding peer advocates.

 

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U.S. Rep. Gwen Moore (D-Wis.), co-chair of the Congressional Caucus for Women's Issues

 

Most important: We need a serious national commitment to reduce premature births and infant mortality - and eliminate racial and ethnic disparities in birth outcomes. We currently have a core program, the Maternal and Child Health Services Block Grant in Title V of the Social Security Act. . . . Experts in the field tell us that we must build upon and expand this program if we truly want to reduce infant mortality rates.

 

Commitment: I support full funding for the Maternal and Child Health Services Block Grant, which has been critically important for Milwaukee. I also support the Healthy Start initiative, which has been vital for the work that the Milwaukee Healthy Beginnings Project (through the Black Health Coalition of Wisconsin) is doing in this area. . . . Both of these programs do good work and make an incredible difference in people's lives. But they could do even more with increased funding.