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Minority infants die before their first birthday at rates as high as twice the national average. In some urban and underserved areas, the rates of infant mortality among minorities are even higher. Across the country, community-based organizations serving African American, Latino and Native American families are employing approaches that engage families, neighbors and peers in reducing infant mortality through education and outreach.

In Chicago, the Illinois Maternal and Child Health Coalition's on-the-ground efforts have reduced infant mortality by almost 40 percent, even as rates in nearby communities have either increased or remained steady. Illinois was one of five states to receive a grant from the Health Resources and Services Administration (HRSA), and as a recipient of funds, IMCHC was able to tackle infant mortality in four communities.

"You have to meet people where they are and that can be different for different people and based on the communities where they are," said Sheila Sanders, project coordinator for IMCHC's Chicago Area Immunization Campaign and associate project manager for IMCHC's Campaign to Save Our Babies. IMCHC created a peer education curriculum to guide health advocates from the community, and incorporated a social marketing campaign tailored by community feedback. These trained health advocates educated their neighbors in churches, at baby showers and in their homes about low birth weight, Sudden Infant Death Syndrome (SIDS), premature birth, sexually transmitted infections and related risk factors of alcohol and tobacco use. Health ads popped up around the city – on buses and inside trains – and laundromats and stores became additional avenues to get the word out with posters and handbills.

"Our goal was to reach everyone-not just everyone who was in childbearing age, but everyone who knows someone who's pregnant," Sanders said.

In Washington, D.C., the Developing Families Center , which provides prenatal care by certified nurse midwives to a largely African American patient population, involves mothers-to-be in their prenatal health and pregnancy outcomes. Patients have access to their own medical records and record their own vital signs and test results so that they can see that they are the determinants of their own care and the health of their babies.

"I knew we could make a difference, but what I could not foresee was the empowering of the families," said Ruth Lubic, C.N.M., Ed.D., who works at the Developing Families Center. Lubic says that she has seen the impact of the personalized approach to foster healthy pregnancy and birth outcomes.

But barriers and challenges still exist.

Although progress has been made in infant mortality rates, Lubic is still urging the health care community to expand what is considered the prenatal period to include the time before conception to age 2.

"If you don't get the mother during pregnancy or while the child is an infant, you've lost the ballgame," she said.

Infant Mortality: Just the Facts

Infant mortality is often seen as an indicator of the health of a nation. Although rates have declined over the years, the United States still falls behind countries such as Cuba, Japan and the Netherlands. In 1960, the infant mortality rate in the United States was 26 deaths per 1,000 live births. Fifty years later, a 2011 report from the Centers for Disease Control and Prevention found that in 2007, the overall infant mortality rate was 6.75 deaths per 1,000 births.

But for African American babies, the rate is almost double - 13.31 deaths per 1,000 live births. The CDC report also cited high rates among American Indian and Alaska Natives babies (9.22 deaths per 1,000) and Puerto Rican babies (7.71 deaths per 1,000). These higher rates have been linked to higher incidences of preterm births (before 38 weeks) and lower birth weight (less than 5 pounds, 9 ounces) in these communities.