undoing racism an essential approach to addressing african american infant mortality
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Undoing Racism An Essential Approach to Addressing African American Infant Mortality. Genesee County Racial and Ethnic Approaches to Community Health (REACH) US October 12, 2011. Genesee County Health Department 10/12/2011. REACH US – Who are we?. - PowerPoint PPT PresentationTRANSCRIPT
Genesee County Racial and Ethnic Approaches to Community Health (REACH) US
October 12, 2011
Undoing RacismAn Essential Approach to Addressing
African American Infant Mortality
Genesee County Health Department 10/12/2011
REACH US – Who are we?
The Genesee County REACH US project is a Center of Excellence in the Elimination of Disparities (CEED) in AA infant mortality consists of 4 components:
Community-based approaches Local Activities Legacy Projects (Including REHDAI) Dissemination/Training
Genesee County Health Department 10/12/2011
REACH US Partners Flint Odyssey House/Health Awareness Center Genesee County Community Action Resource Department
(GCCARD) Genesee County Health Department (Central
Coordinating Agency) Greater Flint Health Coalition Hurley Medical Center Programs to Reduce Infant Deaths Effectively (PRIDE) Priority Children University of Michigan/Prevention Research Center YOUR Center
Genesee County Health Department 10/12/2011
REACH US In 1999 Genesee County became a CDC-
funded REACH 2010 project;
In 2007 GC was designated as a Center of Excellence in the Elimination of Health Disparities (CEED)
GOAL: Reduce racial disparities in infant mortality
with a particular focus on African Americans.
Genesee County Health Department 10/12/2011
Our Problem
Genesee County Health Department 10/12/2011
On average 65 infants die each year (2000-2009 Infant Deaths)
Among white births 5 out of 1000 die, Among black births 18 out of 1000 die,
6,054 births per year (2000-2009 average)
In Genesee County….
Black babies die 3 times more often than other babies
Genesee County Health Department 10/12/2011
48504
Infant DeathsGenesee County
City of Flint/Burton2005-2009
= 1 Black Infant Death
= 1 Other Infant Death
= 1 White Infant Death
N=170
48509
48505
48532
48502
48519
48529
48507
48506
48504
48503
Genesee County Health Department 10/12/2011
Year 1: Develop Community Action Plan (CAP)
Held over 25 focus group with populations of focus
Presented to 35-40 agencies/organizations in the community to garner support
Held community event Presented CAP to community for feedback
Genesee County Health Department 10/12/2011
Community Action Plan (CAP) derived from two points of view: Bench (“Science”)
No single intervention is likely to eliminate racial disparities in infant mortality
The period of pregnancy is simply too short to effectively address many risk factors important to infant health
Trench (“Community”) Language Communication Trust Racism
REACH US
Genesee County Health Department 8/8/2011
“If you always do what you’ve always done, you’ll always get what you’ve always got. If you
want something you’ve never had, you’ve got to do something you’ve
never done.”A.J. McKnight
Genesee County Health Department 10/12/2011
MATERNAL-INFANTHEALTH
FosteringCommunityMobilization
Enhancing the
BabycareSystem
Reducing Racism
Community Action Plan -A Multi-faceted Life-course Approach
Genesee County Health Department 10/12/2011
REACH US – Local Activities MIHAS ACEDC - History & Culture Education PRIDE Medical Services Committee Community Dialogue Action Groups
o Black Men for Social Changeo Women Taking Charge of Their Health Destiny
Undoing Racism Workshops Community Windshield Tours Evaluation
Genesee County Health Department 10/12/2011
Reduce Racism
Community Windshield Tour Facilitated by the MIHAS
Undoing Racism Workshops Facilitated by the People’s Institute for
Survival and Beyond – New Orleans, LA
2 ½ Days REACH US Activities
Genesee County Health Department 10/12/2011
Reduce Racism
Product of Asset Mapping
Designed to provide a visual observation of barriers/resources in the zip codes with the highest infant mortality rates exist
Physicians, hospital personnel, national representatives, foundation/funder representatives, and community residents
Community Windshield Tours
Genesee County Health Department 10/12/2011
Reducing Racism
Undoing Racism Workshops 30 workshops and over 1000+ participants Follow-up working groups:
community residents agencies/organizations
Genesee County Health Department 10/12/2011
Why focus on racism?
Racism is a public health issue ...
“You cannot reduce racial and ethnic health disparities in infant mortality without looking at the role that race, culture, and history plays.” Genesee County REACH 2010 Coalition - April 2000
“Harvard researchers documented that a mere 1% increase in incidences of racial disrespect translates to an increase in 350 deaths per 100,000 African Americans. How? Being on the receiving end of overt or subtle racism creates intense and constant stress that boosts the risk of developing an illness” Sid Kirchheimer, WebMD Health News –January 2003
Genesee County Health Department 10/12/2011
Genesee County REACH US’s Objective for the URW
Facilitate a change in attitude and a critical understanding of the ways that culture and racism affect racial disparities in infant mortality.
Populations of focus audience includes healthcare providers, business leaders, and
community members.
Genesee County REACH 2010 Coalition April 2000
Genesee County Health Department 10/12/2011
82.0% of AAs and 79.1% of EAs said yes: EA goals met:
gaining better insight or learning more about racism how to address racism in work or the community
EA goals NOT met: the URW was focused on the negative/blamed whites there was too little time for group discussion or too little focus on
solutions AA goals met:
gaining more insight about racism find ways to reduce racism
AA goals NOT met: too little focus on what action can be taken to undo racism.
Community Perspectives (2005):Were Goals/Expectations Met?
URW Surveys were developed by REACH 2010 Evaluators. Data was analyzed and presented by Cameron Shultz, PhD
Genesee County Health Department 10/12/2011
Provider Perspectives (2005):Were Goals/Expectations Met? (Yes) “I came to the workshop with a very naïve understanding of race. The
historical perspective opened my eyes, especially recognizing that definitions are not based on biology but politics”
“If you are white you are given preference in most, if not all, fields;…medical access is better provided [to whites] as blacks are thought not to comply to medication”
“open discussion, they let us debate openly”
“it helped me understand how systems can be created to discriminate”
“I liked having an honest perspective from African Americans about what its like to live as an African American in this country”
URW Surveys were developed by REACH 2010 Evaluators. Data was analyzed and presented by Cameron Shultz, PhD
Genesee County Health Department 10/12/2011
Community Perspectives(2009)
95% felt it changed their knowledge about racism
90% felt it changed their attitude about racism 89% stated it would change the way they will
act in the workplace 80% said they would definitely recommend the
workshop to a friend or colleague
REACH US URW Evaluations 2007-2010
Genesee County Health Department 10/12/2011
Action Advocacy (many repeats) Be aware Action research Redefine self Assume responsibility; sense of obligation with the new knowledge Teach providers what racism really is Work with communities in education Teach AA mothers how to care for themselves Help mothers before they become pregnant Share information/progress on MCH strategies and IM Participate in community outreach Support REACH US
What you can do to reduce impact of [racism] to improve AA mother-infant health (2011)
Genesee County Health Department 10/12/2011
Action Listen Foster RELATIONSHIPS Approach churches to empower community Help transport neighbors Become involved in community efforts Become more familiar with area resources in order to appropriately
refer Work to create community that is more aware of social determinants
of health Increase education-awareness Support small/positive business
What you can do to reduce impact of [racism] to improve AA mother-infant health (2011)
Genesee County Health Department 10/12/2011
Foster understanding/awareness Reviewing demographics and disparities Importance of community engagement—participatory
approach Bench-(Science Knowledge)
Infant mortality is a life course issue A multifaceted problem in need of multiple solutions
Trench-(Community Knowledge) Need for enhanced communication and trust; focus on racism
Common definition, history, root causes, institutions, internalized racial oppression and superiority
Undoing Racism Workshop (Linkages to IM reduction…)
Genesee County Health Department 10/12/2011
Awareness/Understanding (cont.) Less self-blame and more system blame Frequent integration of health disparities focus Integration of Windshield Tour
Direct Impact of Racism Stress (physiological damage; allostatic load) Poor health related to…(education, unemployment, housing,
neighborhood risks; diet) Self-neglect ; depression (internalized oppression) Provider mistreatment; healthcare bias (internalized
superiority)
Undoing Racism Workshop (Linkages to IM reduction…)
Genesee County Health Department 10/12/2011
Skills/Call to Action Change in institutions begins with change in self Tools and skills to become more aware and be better
communicators Self-awareness of personal bias Honesty
A return to the social change focus of public health Avoid gatekeeping; empower community Community leadership-advocacy Community organizing experiences and approaches
Undoing Racism Workshop (Linkages to IM reduction…)
Genesee County Health Department 10/12/2011
Change is Possible
Genesee County URW Participant (2008)“Ultimately, I believe that change is possible. I can
dismantle racism through individual efforts in my own sphere of influence. I can affirm diversity by respecting and being open to other races and cultures. I can mentor and volunteer. I have come to realize that my commitment has to be more active and that it is not as daunting as first perceived.”
Genesee County Health Department 10/12/2011
Genesee County REACH US
Shannon Brownlee, MPHREACH US CEED CoordinatorGenesee County Health Department(810) [email protected]
Genesee County Health Department 10/12/2011
Tonya French-Turner, BBAREACH US Program CoordinatorGenesee County Health Department(810) [email protected]
Daniel Kruger, PhDREACH US Program EvaluatorUniversity of MI/Prevention Research Center(734) [email protected]
Denise Carty, PhD CandidateREACH US Program EvaluatorUniversity of MI/Health Behavior & Health Education (608) [email protected]