Data to Action Success Stories: New Jersey

Reducing Black Infant Mortality

Summary

State officials in New Jersey used Pregnancy Risk Assessment Monitoring System (PRAMS) data to explore causes of racial disparities in infant mortality rates and provide the state’s Healthy Women, Healthy Families Initiative with information to support community-based approaches to reduce Black infant mortality.

Problem

• In 2017, the infant mortality rate for Blacks in New Jersey was more than 3 times that of Whites, a disparity that had remained constant for at least 10 years.
• Improving maternal and infant health and reducing Black infant mortality was a top priority of the New Jersey Department of Health (NJDOH) and New Jersey Governor’s administration.

PRAMS Data to Action

• In 2018, the New Jersey (NJ) PRAMS team analyzed PRAMS data from 2012–2015 on topics that include timing of prenatal care, barriers to receiving prenatal care, experiencing stressful life events, attending postpartum visits, experiencing postpartum depression, breastfeeding, and bedsharing.
• These data highlighted important issues to address. For example, Black mothers had the lowest rates of post-partum checkups (81.9%) and breastfeeding initiation (81.4%). They also had the second highest rates of post-partum depression symptoms (14.3%) and report of often bed sharing (32.4%).
• Results from the NJ PRAMS analysis and information from other sources were used to create fact sheets on root causes of black infant mortality that were shared with the NJDOH Commissioner and the NJDOH Black Infant Mortality Task Force.

Results

• In 2018, staff from NJDOH Reproductive and Perinatal Health Services, and the NJ PRAMS Team used results from the root cause analysis and focus groups to develop a new Healthy Women, Healthy Families (HWHF) Initiative. The goal of this 5-year initiative (2018–2023) is to improve maternal and infant health outcomes while reducing racial, ethnic, and economic disparities through a coordinated community driven approach.
• The NJDOH Commissioner appropriated $4.7 million per year in grant funding to community-based organizations for the first 2 years of the HWHF Initiative.
• The HWHF Initiative used this funding to award grants to 8 community-based organizations that operate statewide in 12 regions to carry out case management services using community health workers, developing diverse community partnerships, and convening a diverse community advisory board. Each region uses a referral specialist(s) and community health workers that operate as a point of contact to help people in their communities.
• Case management programs to address Black infant mortality through this initiative can include group prenatal care, community doulas, and programs such as breastfeeding and fatherhood support groups.
• By the end of year 2, NJDOH trained 79 doulas, hired 30 community health workers, and hired 13 community health worker supervisors.
• As of June 2020, almost 49,000 women have received case management services and over 25,000 women have been referred to programs such as Home Visiting and Healthy Start.