Newswise — The Program for Community Engagement and Implementation of the Translational Science Institute at Wake Forest School of Medicine recently concluded a workshop series that focused on infant mortality in Forsyth County.
Held in collaboration with the Forsyth County Health Department and the Infant Mortality Reduction Coalition, the intent of the series, “Poor Birth Outcomes in Forsyth County,” was to address how the larger community can help improve poor birth outcomes. The audience for the workshops was comprised of leadership from many different community organizations.
“Poor birth outcomes, such as very low birth weight and infant death, result from a complex set of factors. The focus of this workshop series was the role of social and cultural factors in poor birth outcomes,” said Thomas A. Arcury, Ph.D., director of the Program in Community Engagement and Implementation. “Social and cultural factors include neighborhood environmental exposures, the accumulation of life-time deficits in nutrition and health care, and the stress that results from poverty and discrimination.”
Arcury, who is director of the Program in Community Engagement and Implementation and a professor and vice chair for research in the Department of Family and Community Medicine, said the goal of the Translational Science Institute is to work with community residents, organizations, and agencies to develop a research project that will define the social and cultural factors that result in infant death and low birth weight in Forsyth and surrounding counties.
According to the Forsyth County Infant Mortality Reduction Coalition, the infant mortality rate the county for 2010 is 9.9 infant deaths for every 1,000 live births, compared to 7.9 for the state and 6.86 for the country. The leading cause of infant death is premature birth and low birth weight. The School of Medicine’s Department of Pediatrics reports that approximately 75 percent of infant deaths are related to prematurity.
The first workshop explored the current state of knowledge, as well as unanswered questions, about the causes of infant mortality. Robert Dillard, M.D., was the program presenter. He is Medical Director of Forsyth Medical Center Neonatal ICU and Professor of Pediatrics at Wake Forest School of Medicine.
“Previously, it was believed that good prenatal care would solve the problem of low and very low birth weight babies,” said Kathy Lowe, M.S.W., assistant director of the Program in Community Engagement and Implementation. “We now know that prenatal care, although helpful in identifying many potential risk factors for pregnant women and their babies, is, by itself, insufficient in reducing infant mortality.”
The goal of the second workshop was to shed light on the myriad factors that are implicated in low and very low birth weight babies such as stress, poverty, racism, pollution and culture and how they contribute. Of the five urban counties in North Carolina, Forsyth County has the second highest overall rate of infant deaths in the state and, in contrast, has top-rated medical facilities and providers.
Diane Rowley, M.D., M.P.H., Professor of the Practice of Public Health, Maternal and Child Health at UNC Chapel Hill, was the presenter. Rowley’s research interests focus on health disparities in premature birth.
The final workshop brought together a panel of participants representing different sectors of the community to achieve a better understanding of the problem, as well as propose specific actions in the areas of research, intervention, and policy. The seven community perspectives were Forsyth County Health Department, the medical and faith communities, Department of Social Services, Winston-Salem/Forsyth County Schools, Forsyth County government and United Way/Chamber of Commerce.
“For this workshop, we discussed what works,” Lowe said. “If it ‘takes a village’ to raise a child, then perhaps it also takes a community to support a pregnant woman in having a healthy baby.”
Twana Wellman-Roebuck, executive director of the Experiment in Self-Reliance, served as moderator for the panel that was composed of the following individuals: Faith Lockwood - Winston-Salem/Forsyth County Schools; Lynne Mitchell - Forsyth County Public Health Department; Kimberly Nesbitt - Forsyth County Department of Social Services; Rev. Prince Raney Rivers - Faith Community; Carmen Strickland, M.D., Wake Forest School of Medicine; local attorney Mike Wells - United Way/ Chamber of Commerce; and Everette Witherspoon - Forsyth County Commissioners.
As a result of the workshop series, said Lowe, two initiatives resulted. The first will bring sponsoring groups together to collaborate on a research proposal in response to a National Institutes of Health grant funding opportunity to further explore the lack of understanding regarding the problem of poor birth outcomes. The second initiative is the collaboration of community organizations to positively impact the problem through education, to distribute information, create materials that tell a personal story and develop mentoring programs that match pregnant mothers to nurturing supporters. This collaboration also will encourage businesses to address this topic, encourage policy changes at the governmental level that prioritize the care needed to support pregnant women, and increase the community’s will and ability to acknowledge and address the problem of infant mortality.
“Infant mortality is a community problem that requires community-driven solutions,” Arcury said.
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