Office of Minority Health

Grantee Information

Organization: Minnesota Department of Health (MDH), Center for Health Equity (CHE)

Organization Address: PO Box 64975, Saint Paul, MN, 55164

Phone Number: 651-201-5949

Fax Number: 651-201-4986

Organization website URL (if any): http://www.health.state.mn.us/divs/che/

Brief Description of the Organization: The Commissioner of Health established the Center for Health Equity (CHE) in 2013 to advance health equity and to make it an essential goal for a healthy Minnesota CHE engages communities to address structural racism and inequities that contribute to health disparities; advances health equity in all of MDH's activities (e.g., grants, workforce development, and policy making); collects, analyzes, and communicates data on health, health disparities, and invests in reducing health disparities through grants; increases cultural understanding and deepens relationships with communities, and engages citizens in decision-making; and, focuses on creating health for all Minnesotans through a health in all policies approach.

Grant Project Information

Title of Grant Project: Addressing Infant Mortality among African Americans

Amount of OMH Award: $195,000

Name of Project Director: Melanie Peterson-Hickey

Phone Number of Project Director: 651-201-5849

E-mail Address of Project Director: melanie.peterson-hickey@state.mn.us

Abstract

The project addresses a wide spectrum of factors that contribute to the high infant mortality rate among U.S. born African Americans living in Hennepin County MN via a community engagement model. In Hennepin County, Minnesota’s largest county, the U.S. born African American infant mortality rates are 3.4 times higher than the Caucasian rates. The difference in the infant mortality rates may be explained not only by variations in maternal characteristics, behaviors and access to health care, but also by other factors including social issues and individual and family circumstances. The community engagement model is designed to bring the perspectives and understandings of the community about the factors that create and sustain disparities, and to stimulate the community to address these factors through a health in all policies approach. The main products of the project will be two Health Disparity Profiles, a Health Equity Narrative and a Comprehensive Plan to Address Infant Mortality in Hennepin County, Minnesota.

The project includes the following goals:

• To strengthen African American communities capacity to change the conditions, maximize the opportunity for a healthy start, and to eliminate the disparities in infant mortality in Minnesota;
• To empower African American communities to advance a health equity narrative that includes all of the factors that contribute to infant mortality among this population in Minnesota;
• To eliminate disparities in infant mortality among African Americans in Minnesota.

This project has four main components:

• Health Disparity Profiles – Community leaders and MDH project staff will work together to create Health Profile Part 1 to describe infant mortality among U.S. born African Americans in Minnesota and Hennepin County. The profile will build on the narrative work that is also part of this grant to create a health equity description of the health of mothers, infants and families. The profile will not only describe traditional birth outcomes (e.g., prematurity, low birth weight), but it will also describe socio-demographic characteristics of the mother and environmental characteristics of her community. Additionally, the profile will also describe the health and socio-demographic characteristics of African American youth in Hennepin County. Health Profile Part 2 will build on Part 1 and meaningfully explore the causes driving inequities in infant mortality. Part 2 will examine the policies, systems, and environments that have created differences in the determinants of health (e.g., education, housing, food insecurity, health care, and employment).

• Community Engagement – A primary focus of the MN OMH SPI project is the creation of a partnership between the African American community and MDH using a community engagement model. For partnerships to occur, project staff must ensure that all voices can be heard, that leadership from the community is valued and nurtured, that community assets are identified and leveraged, and to the greatest extent possible, community members are making priority-setting and decision-making throughout the process. An authentic partnership from the beginning of this project will ensure that strategies will truly reflect the needs of the African American community and utilize the strengths of the community–all of which will be defined by the African American community. The project will conduct community engagement and leadership trainings throughout the grant cycle and will utilize a community engagement model for all aspects of the grant project, including the development of Health Profiles, developing and refining the Health Equity Narrative, and the development and implementation of the Strategic Plan.

• Health Equity Narrative – The MN OMH SPI project will develop a health equity narrative for infant mortality in the U.S. born African American community in Hennepin County to identify, prioritize and implement efforts that address the range of factors that contribute to infant mortality. The shift to a health equity narrative will elevate that narrative that health is determined not only by individual behaviors and access to health care, but also the conditions in which African American communities live, work, worship and play, and the policies and systems that create these conditions. The end-result will be a broader perspective on the causes of African American infant mortality for community members, policy makers and agency staff with a better sense of possible solutions to address this persistent inequity.

• Comprehensive Plan to Reduce Infant Mortality – Community partners and MDH will develop recommendations for a comprehensive plan to reduce infant mortality. The plan will incorporate findings from both health profiles and the health equity narrative. The strategy will include recommendations for interventions for all determinants of health. The recommendations will address both the public health arena and changes that must occur in other arenas (i.e., social determinants of health) that are not always seen as the responsibility of public health. In addition to a health equity analysis that shifts the narrative about health, what contributes to health, and the work that public health needs to be doing or doing differently, MDH will engage the community in the process of identifying strategies, priorities and implementation strategies.

The anticipated outcomes of this project are that the community and agencies develop a shared vision, priorities, and interventions; the community’s capacity to create its own healthy future is strengthened; communities are involved in organized change efforts to improve key conditions for health, are organizing their own change efforts, and are using public health data to support policy and systems changes. Additionally, Community Voices and Solutions Group (CVAS), staffed by MDH/CHE, and other community members will have a greater understanding of all factors that determine the health of U.S. born African American mothers and infants in Hennepin County. Further, a health equity narrative will become the dominant narrative for infant mortality in Minnesota.

The evaluation plan for this project includes a combination of process, outcome and summative measures. Evaluation data will be collected through: partner and community surveys; storytelling; key informant interviews; observations; document reviews (state/local policies); and, existing surveillance systems. Questionnaires and focus groups (community members and leaders) will be used to document changes in knowledge and awareness of infant mortality issues and health equity, as well as changes in leadership skills, community engagement, and narrative development. MDH staff will produce and disseminate materials within MDH and the community through various formats and media–including reports, summaries, and articles.

NATIONAL PARTNERSHIP FOR ACTION TO END HEALTH DISPARITIES GOALS

None identified by the grantee.

RELATED HEALTHY PEOPLE 2020 OBJECTIVES & SUBOBJECTIVES

None identified by the grantee.