Incorporating Life Course Theory into FIMR , continued from page 3


well as a change in the path of a generation.”


—Michelle Reese, Executive Director, MReese@hmhbbroward.org


Michigan Department of Community Health ‘Integrating Life Course Theory into Michigan’s FIMR Projects’ Rosemary Fournier, State FIMR Program Coordinator


Michigan is persistently above the national infant mortality rate, in both overall IM and African American IM due to the high disparity. Michigan’s 2010 White IM rate of 5.5 and Black IM rate of 14.2 are significantly higher than the national rates. Additionally, African- American infants in Michigan are dying at a ratio of 2.6 times higher than White infants. Michigan currently ranks 39th among states for overall infant mortality and 47th among states for Black infant mortality. First, the team is planning a statewide


daylong Symposium on the Life Course Theory for all the FIMR personnel in the 14 existing sites. The team is also planning to increase local FIMR teams’ capacity to obtain maternal interviews by offering incentives. Currently, no FIMR site in MI offers incentives. The third step for integrating LCT into the FIMR methodology in Michigan will be outreach to the CRT and CAT members who were not able to attend the initial symposium. The highlights of the workshop will be incorporated into a PowerPoint presentation, and the State FIMR coordinator, will conduct mini presentations for all of the State’s existing and developing FIMR programs. Lastly, the resources of the NFIMR Small Grant Funding Award will be used to develop tool kits for the local FIMR to use, to increase their ability to shape recommendations around Dr. Lu’s 12 point plan to reduce infant mortality. (For more information about the Plan, see In the Literature, p. 6)


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“Using a Life Course approach will encourage Michigan’s FIMR Case Review and Community Action Teams to even more deeply


explore and address the issues contributing to infant deaths over a lifetime and across generations rather than focusing on a specific time in a woman’s life. The FIMR/Life Course opportunity supports our defined objectives: improving health outcomes, eliminating racism, and moving toward equity.”


— Rosemary Fournier, State FIMR Program Coordinator, FournierR1@michigan.gov


Douglas County Health Department, Douglas County, NE ‘Leveraging Integration For Excellence’ (LIFE)


Nebraska’s most populous county, Douglas County, has been employing FIMR methodology in collaboration with Omaha Healthy Start to identify system changes relating to infant mortality since 2006. Dr. Michael Lu, who currently is the HRSA Associate Administrator for MCH, introduced the Life Course Theory to the Omaha community in 2005, and various programs have been developed under the LCT framework. The team has plans to update CRT forms to sort risk items under umbrella topics as well as adding protective factors. Bereavement materials are going to be offered as incentive for maternal interviews and all materials will be updated to include the LCT framework.


“Every mother should have an equal opportunity to dream about her future family. Only by helping every women have economic,


social and environmental opportunities, as the Life Course helps us to do, can we be sure that this equal opportunity exists.”


— Carol Isaac, FIMR/CRT Coordinator, Carol.Isaac@douglascounty-ne.gov


Milwaukee FIMR, Milwaukee, WI ‘Integrating Life Course Theory and Father’s Perspectives in FIMR Assessment, Review,


and Training Process’


Milwaukee has one of the most striking disparities in infant mortality in the


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


nation. According to the 2010 Milwaukee Health Report, the rate for African Americans (14.8/1,000) is over three times that of whites (4.7/1,000), with the Hispanic rate at 5.7/1000. Disturbingly, these disparities appear to be increasing. The longest standing FIMR review team in the state, Milwaukee FIMR consists of about 40 professional and community members and it represents over 22 agencies, HMO’s and community organizations. Milwaukee FIMR aims to educate and establish a common understanding or language of LCT among Milwaukee FIMR team by developing and conducting a training session covering LCT. This training session will establish a common understanding of the life course theoretical framework as well as introduce the “Life Course Game” and discuss its potential use in informing the FIMR review process. In addition, the team is working on paternal involvement and engagement (PIE) efforts in LCT. They plan to incorporate paternal perspectives into the proposed FIMR/LCT review process by conducting two focus groups of fathers.


“Milwaukee FIMR’s Case Review Team began talking about justice and fairness some time ago but the incorporation of a specific set of life course objectives will allow us to track our success or failure over time, and encourage Milwaukee to include these issues whenever a public health concern is addressed. Milwaukee’s Healthy Start is represented on the FIMR Case Review Team and both the FIMR Principal Investigator and FIMR manager provide data and evaluation support to the Healthy Start program.”


Karen Michalski, FIMR Coordinator, KMICHA@milwaukee.gov


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