For a city with excellent medical facilities, St. Louis has a surprisingly high infant mortality rate, with some zip codes suffering from more infant deaths than do some third-world countries. In fact, every week, an average of five babies die before their first birthday in St. Louis.
Complications from preterm births (those that occur prior to the full 37 weeks of gestation) are the leading cause of newborn deaths. Given that rate of preterm births can be abated with better prenatal care and medical support networks for pregnant women, infant mortality is entirely preventable in the realm of health care. However, it is debatable whether or not infant mortality is a practically preventable outcome.
The well-being of newborn babies goes beyond the clinical setting: infant health determinants — such as the mother’s housing conditions, means of transportation, educational level, mental health status, drug usage — are inextricably tied to the mother’s socioeconomic statuses. Thus, a newborn’s life is at the mercy of pre-existing, systematic barriers faced by their mothers.
Amidst the affluent communities of St. Louis, the legacy of housing segregation policies from the last century has entrenched isolated islands of poverty. Such institutionalized practices have concentrated socioeconomically-disadvantaged African Americans into certain neighborhoods. The lack of tax support in these regions impede residents’ access to many resources, including transportation, income, education, and nutrition. These impediments translate into risk factors for preterm birth complications. As a result, African-American infants are three times more likely than white infants to die before the age of one.
Flourish St. Louis is an emergent initiative that has resolved to celebrate a happy and healthy first birthday of every baby in our community. Led by the Maternal, Child & Family Health Coalition, which is partnered with the Missouri Foundation for Health, the program aims to effect a systemic level of policy change by fostering a collaboration of community members. In bringing together different sectors of our community that represent various pieces of the puzzle, Flourish St. Louis can leverage the efforts of multiple organizations to solve the common problem of infant mortality. The program has formed a Cabinet of community leaders and impacted parents. Together, they analyzed local data and personal stories concerning infant mortality then reviewed initiatives undertaken by other cities.
Kendra Copanas, the Executive Director of the Maternal, Child & Family Health Coalition, commented on the collaborative aspect of the initiative and encouraged involvement:
“Our Think Tank is developing a shared system of measurement. So, instead of focusing on the isolated impact of a single organization, we are creating a measurement system that can assess. This will bring greater alignment and create more collaborative problem solving, as well as help form an ongoing learning community that will increase the effectiveness of all sectors and organizations working on this issue. The whole community can get involved in these efforts – from writing an encouraging letter for a mom-to-be that’s facing tough times to joining a workgroup when the Cabinet launches our strategic priorities. To learn more about how you can get involved, visit www.flourishstlouis.org” (personal communication, March 1, 2016).
Overall, infant mortality is a complex issue that can only be resolved through increased awareness and community mobilization. Flourish St. Louis has taken the first initial steps to determine an ideal set of social policies our society should adopt to rectify this preventable issue. It is our civic duty to take action accordingly.
The content of this article, including pictures of slideshow, is from a joint presentation given by Kathleen Holmes of the Missouri Foundation for Health and Kendra Copanas of Maternal Child & Family Health Coalition at Washington University.
Copanas, Kendra and Holmes, Kathleen (October 28, 2015). Inequalities in St. Louis Birth Outcomes.”