In Grand Rapids, Michigan, women of color are receiving maternal-child health support, ensuring their children have a healthy start.
This support comes from a consortium of eight community organizations known as Strong Beginnings. The organization is dedicated to improving maternal-child health in communities of color, which have higher infant mortality rates than their white counterparts.
The W.K. Kellogg Foundation grantee promotes racial equity and father engagement, and works to address issues affecting maternal-child health like poverty, unemployment, limited transportation and a lack of affordable housing.
Strong Beginnings Program Director Peggy Vander Meulen said poverty and institutional racism prevent African American and Latina women from accessing the same opportunities as white women. Of the 825 families Strong Beginnings served in 2015, 25 percent had been homeless, all were living in poverty and many were dealing with depression and high stress. Despite these challenges, the women showed an amazing resilience and desire to do the best they can for their children.
"We do know that pregnancy outcomes and health status are far more dependent on those social determinants than straight medical care,” Vander Meulen said. “The underlying reason for health disparities between people of color and those who are white is racism, both individual and institutional racism."
African-American infants born in Grand Rapids are 2.2 times more likely to die than white infants, according to 2015 data from the Michigan Department of Health and Human Services. For Latina women in Kent County, records show there were 6.1 infant deaths for every 1,000 births compared to 4.5 for white women from 2012-2014.
Strong Beginnings employs 20 community health workers, who help educate and encourage women throughout their pregnancies and through the first two years’ of their infants’ lives. Staff, many of whom are former program participants, go into Grand Rapids’ most vulnerable neighborhoods to listen to the concerns of mothers and enroll them into Strong Beginnings programs. A fatherhood program provides similar services to male partners.
“Community health workers have a very unique set of skills and perspectives that comes from their lived experience in the communities that they’re serving,” Vander Meulen said. “They deeply understand the obstacles our families are facing and then hold them up to say, ‘I believe in you, you have so much potential and we can do this together.’”
Community health workers partner with nurses and social workers at Kent County Health Department, Cherry Health and Spectrum Health MOMS on case management teams and connect families to job placement, transportation and housing resources.
They take a holistic approach to improving participants’ overall health with therapists on staff to provide mental health counseling, offering peer support groups and providing tools to help participants develop self-esteem and set goals for themselves and their children.
"We have to address the whole person; it’s not just their physical body, but also their mind, spirit and emotions,” Vander Meulen said.
Strong Beginnings staff also works to combat premature births and low birth weights – the most common causes of infant mortality – and has succeeded in keeping the infant mortality rates of its African-American participants below the city’s rate of 11.5 infant deaths per 1,000 live births.
“The infant mortality rate among our clients is far lower than the overall Grand Rapids or Kent County rates,” said Vander Meulen, adding that infant mortality rates of its African-American-female clients from 2012-14 was half the rate of African-American women living in Grand Rapids.
In 2015, the program released a quasi-experimental design study illustrating their impact on clients. The study showed Strong Beginnings’ African-American-female clients significantly face more barriers than African-American women on Medicaid in Kent County including poverty and depression, but receive better prenatal care than their counterparts.
Among its findings, 65 percent of Strong Beginnings clients receive first trimester prenatal care compared to 58 percent of Medicaid recipients. Additionally, Strong Beginnings clients receive more postpartum exams and well-child visits than Medicaid recipients.
Strong Beginnings staff also encourages new mothers to breastfeed, which help protect infants from chronic and infectious disease. The organization offers a weekly breastfeeding support group and numerous parenting and education programs to the community at large. Of the women who participate in the program, 72 percent initiate breastfeeding and 33 percent breastfeed for six months or more.
Shaunte Paul-Oliver, a mother of four, has participated in the breastfeeding program since giving birth to her youngest children Alona, 5, and Alonte, 2. She said the program made her feel comfortable about breastfeeding her daughters.
"I was one of those people who didn’t want to do it in public, but going to the classes showed me there’s no reason to be embarrassed,” Paul-Oliver said.
Though the work to address maternal health issues facing communities of color is ongoing, Vander Meulen believes Strong Beginnings is helping to change the narrative for those families.
"We are reaching the most vulnerable families and helping them achieve good outcomes,” said Vander Meulen.