Incorporating Life Course Theory into FIMR , continued from page 1


identified community members, social workers, and other partners who are also working on health equity. The grant funds will go towards strengthening these relationships as well as evaluating the effective of the NATs.


“Baltimore’s City Fetal and Infant Mortality Review program drives our B’more for Healthy Babies strategy to improve our


population-based birth outcomes. Our use of Life Course Theory has helped us better allocate our resources to implement a preventive model of care and work closely with grassroots partners such as Healthy Start.”


—Cathy Costa, Program Manager, Cathy.Costa@baltimorecity.gov


Contra Costa County FIMR, Contra Costa County, CA ‘Promoting Health Equity: Reducing African American Fetal


& Infant Morality’


Contra Costa County, located in the San Francisco Bay Area in California, is an economically and racially diverse region with over a million residents. African American women are more than twice as likely to have a fetal and/or infant death as white women. Contra Costa FIMR has been working on health disparity issues by collaborating with other community organizations such as the Contra Costa Black Infant Health Program. The FIMR team plans to create a


provider assessment tool to help as well as amend maternal interview questions, checklist and protocols that incorporate father of the baby involvement. They will also promote community action in West Contra Costa County, which is a much more ethnically diverse community. Team members have already created a PowerPoint to use for education on Life Course Theory to educate providers.


“FIMR LCT is an educational, strategic and ‘best practices’ initiative


to engage in relationships, dialogue, and action about why African American


women have less reproductive potential, and the reasons twice as many black babies die than white babies. In Contra Costa, women, their families, providers, policy makers, and communities promote Health Equity by learning about the social determinants of health and life course protective and risk factors, and by engaging in a community action collaborative to reduce African American health disparities, such as the African American Health Empowerment Collaborative and the African American Community Baby Shower Planning Committee.”


—Suzzette Johnson, Contra Costa County FIMR Coordinator, Suzzette.Johnson@hsd.cccounty.us


Delaware FIMR under the Child Death, Near Death and Stillbirth Commission (“CDNDSC”), DE “Using the Life Course Theory (LCT) as a Framework for Case Review and Reporting”


Geographically the second smallest state in the US, Delaware has one of the highest rates of infant mortality. There are only two FIMR case review teams (CRT) which allows for a statewide approach to the case review process. The Delaware FIMR team is planning on increasing maternal interview (MI) incentives to get more participation from mothers. Current Care Review Team forms will also be revised and updated based on LCT to better present the mother’s perspective and capture key life course issues. The team plans to conduct two months of targeted case reviews from high-risk communities in Delaware, after which they will report FIMR findings in a new framework that considers life course principles.


“Delaware is excited about the incorporation of the LCT in our FIMR deliberations and the annual report. This perspective


makes sense and is intuitive for a holistic view of a woman’s life and pregnancy. We plan to work closely with the Delaware Healthy


Mother Infant Consortium to give action to FIMR deliberations and recommendations.”


—Project Director Anne Pedrick, Anne.Pedrick@state.de.us


Broward County FIMR, Broward County, FL ‘Life Course Theory Initiative’


Broward County, located along the southeastern coastline of the State of Florida, is the second largest county in Florida and 16th largest in the U.S. The Broward County team is working to engage fathers more effectively to ensure a more thorough understanding of the social issues that played a role in the loss of the child. They are also refining data collection tools to better capture questions about social determinants of health. The Broward FIMR program also plans to update the maternal interview form to reflect the Life Course perspective and capture social protective and risk factors over each mother’s life course. In addition, a paternal interview will be more actively sought and a form will be developed modeling the maternal interview to incorporate father-focused questions. Finally, plans are being put in place to increase coordination among delivery hospitals to ensure that all families in need of bereavement support get more immediate follow up thus leading to more interviews when a death is selected for case review.


“By looking at the past life experience of mothers and fathers, we open the door to a brighter future for the


Broward Community. We need to ensure that stakeholders here in Broward County understand that there are many factors that contribute to a poor birth outcome. Gone are the days of looking only at what took place during the mother’s prenatal course. We want more specific targeted intervention for families who have suffered a loss. The Life Course perspective will help us put all the pieces of the puzzle together and create a clear picture of the social determinants that play a critical role in ensuring a healthy future for that child as


A publication of the National Fetal and Infant Mortality Review Program • 202.863.2587 3


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