An early morning summit by FLOURISH St. Louis on Friday, November 10 brought together groups combatting infant mortality in the St. Louis area at the beginning of Veterans Day weekend. This group of health professionals and insurance managers are looking at barriers that hinder good prenatal and infant care.
“Many sleep-related deaths are preventable, yet they still occur too often,” said Melinda Ohlemiller, CEO of Nurses for Newborns – with an alarming race-based disparity. “Black babies, regardless of where they live, are four times more likely to die in their sleep than white babies
FLOURISH St. Louis data indicates that 260 babies die before their first birthday each year in St. Louis. In fact, the infant death rates in St. Louis and surrounding communities are so high that businesses that are normally competitors are working together to tackle this problem.
“This is another prime example of how the FLOURISH approach helps bring together organizations that once worked independently – the silo effect – to address the issue of infant mortality collaboratively and to reach beyond traditional medical and public health solutions,” said Melba Moore, director of the St. Louis Health Department.
FLOURISH announced some key collaborations that address underlying infant-mortality issues. Managed care providers Home State Health, Missouri Care/Wellcare and United Healthcare have come together to standardize the way they provide transportation service for Medicaid patients. The new initiatives will make it easier to access care for the 20 percent of St. Louis households that do not own a car or the more than one-third of residents who do not live near a public transit hub.
“FLOURISH listens to moms who live this experience, and they told us that access to transportation is one important context in infant mortality,” said Kendra Copanas, executive director of Generate Health St. Louis, the organization leading FLOURISH St. Louis’ efforts. “It’s a very cumbersome system to get around in St. Louis if you don’t own a car.”
FLOURISH’s transportation action team came up with three areas to improve transportation that would benefit Medicaid recipients and health care providers.
“We can identify state policy implications and advocate for the importance of transportation; and align and inform the region’s public transportation,” Copanas said. “This is a health issue.”
Other collaborations included a grant from the BUILD Health Challenge to improve medical transportation access. FLOURISH is working with the City of St. Louis Department of Health, SSM Health, Project LAUNCH/Vision for Children at Risk, and St. Louis Children’s, Barnes-Jewish and Mercy hospitals.
FLOURISH also is advocating for additional funding for the St. Louis portable crib program, which had funding cut in October.
Area hospitals are being encouraged to become infant-safe-sleep certified through the national organization Cribs for Kids, committing to always model best practices when babies are in the hospital and educate parents on infant sleep safety.
“Parents learn so much from watching medical professionals, so we applaud those who are taking steps to make sure safe sleep is a priority,” Ohlemiller said. Cardinal Glennon Children’s Hospital is safe-sleep certified and other hospitals are in stages of certification, she added.
Ohlemiller said some risks are outside of a family’s control. FLOURISH and the St. Louis Health Department are advocating for residents in the mice-infested Clinton-Peabody housing – where the rodents are creating serious health and safety risks for infants and children.
“Mice were found in the apartment complex’s pantries, food boxes, ovens, drawers, cribs,” Ohlermiller said. “One mom documented 52 mice in her home within the complex. The city health department found 22 of 31 buildings in this development have mice and babies, and children live in the majority of these units. Residents’ requests for relief have gone unaddressed, literally for years. Can you imagine living like this? Think about infant safety.”
Mice can bite, of course, and they can trigger allergies, asthma and other serious conditions for small children and pregnant mothers. Parents may think they are protecting the babies from the mice by putting them in the bed with them – where they could suffocate.
Babies should sleep on their backs in a crib or pack-n-play on a firm mattress with a fitted sheet, without blankets, pillows, soft toys or other bedding that could obstruct breathing.
After the opening session, participants selected two 15-minute breakout sessions to go further into quality prenatal care, safe sleep environments, behavioral health services and transportation access. FLOURISH St. Louis also wanted to find creative opportunities to bring (and fund) prenatal care for expectant mothers into safe, non-traditional settings where they naturally gravitate, such as schools.
“It could be a church, could be at a library, it could be a grocery store – we have clinics in grocery stores, why not prenatal care?” Copanas said. “That is really an exciting solution to do that because you have the pharmacy, you have the health care and you have food. And Medicaid will provide transportation to your health-care appointment and to pharmacy. You can use that opportunity to then get fresh food. It’s a great way to use resources and for families to get their needs met.”
The summit took place at 24:1 Cinema in Pagedale. Infant health data on Pagedale (zip code 63133) from the Missouri Department of Health and Senior Services indicates the city has 40.9 percent of infants born to mothers with less than adequate prenatal care, 17 percent pre-term births, and 23.3 percent of babies born with low birth weights. Its five-year infant mortality rate is the highest on the Missouri side of the St. Louis region at 15.1 percent per 1,000 live births. In the Metro East, East St. Louis and Washington Park, Illinois (zip code 62204) are even higher, at 15.9 percent per 1,000 live births, according to Illinois Department of Public Health Data reported in the 2017-2018 edition of “Children of St. Louis: A Data Book for the Community by Vision for Children at Risk.”
Major regional health care, housing, community service organizations, St. Louis city and county government and elected state leadership were represented among the 75 participants for the summit. Attendees committed to take steps to help address infant mortality in the region by increasing health care access, transportation resources and new funding for portable crib donation programs.
“We referred to the summit as a ‘regional call to action,’ because to address this complex crisis, our leaders in all major sectors must align around this important issue,” Copanas said, adding, they cannot do it alone. “We expect the summit attendees to bring information and ideas back to their organizations and to commit to actions that help more babies live to celebrate a happy and healthy first birthday.”
For more information, visit www.FLOURISHstlouis.org. The March of Dimes offers safe sleep tips for babies at http://bit.ly/2iYq8OU.
