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Mon October 8, 2012
Three possible solutions to reduce the racial disparity in infant deaths
Infant mortality rates in Michigan are better than they used to be, but still not good enough.
Seven out of every 1,000 babies born in Michigan will die before their first birthday. This isn't a statistic the state is proud of, and lately there's been a lot of effort put into lowering this number.
#1: Progesterone gel treatment
Dr. Sonia Hassan is the medical director at the Center for Advanced Obstetrical Care and Research at the Hutzel Hospital in Detroit. Dr. Hassan has been doing a lot of research involving babies and pregnant moms - specifically: pregnant women who have a short cervix, which is a major factor in preterm birth.
Recently Dr. Hassan helped spearhead a worldwide study involving 465 pregnant women and a particular type of gel, a progesterone gel applied vaginally, as a possible treatment for those women with short cervixes.
"We found that the women who got the progesterone had a reduction in the rate of preterm birth of about 45 percent," says Dr. Hassan.
That means almost half of the women who were given the progesterone gel carried their baby to full term. That type of result was completely unexpected. Even Dr. Hassan was stunned.
The study opens up the possibility that administering the gel could save a lot of infants' lives in the state. It could also save a lot of money. Dr. Hassan estimates that if health providers screened 100,000 women for short cervixes and administered the progesterone gel when needed, health care costs would decrease by $19 million a year.
Not all health insurances currently cover cervical screenings, but that's about to change. Within in the next year, cervical screening will become standard for all pregnant women in Michigan during their second trimester.
But the gel is just one piece of the puzzle.
#2: Enroll low-income women of color into community wellness programs
While the progesterone gel is directed towards pregnant women, a new initiative in Detroit is trying to reach women before they become pregnant.
Sew Up the Safety Net is funded by a $1.8 million grant, and is a collaboration between four Detroit area health systems: Henry Ford Health, Detroit Medical Center, Oakwood Healthcare System, and St John Providence Health.
The goal of the program is pretty simple: sign up 1,500 at-risk women from three Detroit neighborhoods, the vast majority of whom will not be pregnant. By reaching women before they get pregnant and trying to improve their access to care and knowledge, Sew Up the Safety Net hopes to improve their chances of having healthy babies.
Henry Ford Hospital's Dr. Kimberlydawn Wisdom is spearheading the program. "We know that a woman has to be healthy prior to her pregnancy," Wisdom says. "[That means] having access to fresh fruits and vegetables, safe environments to exercise, a controlled blood pressure...a healthy weight."
The 1,500 women who will participate in Sew Up the Safety Net will be tracked over the next three years to see if the approach works, and if it can be replicated.
#3: Increase access to quality health care
The Affordable Care Act, otherwise known as Obamacare, includes a provision that stands to benefit millions of low-income women across the nation.
Right now if you're low-income and pregnant you're likely covered by Medicaid during and right after the pregnancy. But if you're a low-income woman who is not pregnant, chances are you don't qualify for Medicaid and can't afford health insurance on your own.
Currently, four out of ten women with incomes below 200 percent of poverty do not have health insurance.
"How can we help women become healthy and come to a pregnancy ready with their own health and well-being if we're not helping them get preventative care," Johnson says. "We've failed to invest in women before pregnancy, and it's a big gap in this country."
Johnson says low-income women of childbearing age will then have the opportunity to receive preventative services like well-women visits and screenings. These services might stave off chronic conditions that are known to lead to preterm pregnancies like hypertension and diabetes.
These are just a few of the efforts underway to help lower Michigan's infant mortality rates. Tune in to Michigan Radio's State of Opportunity documentary Tuesday, October 9th at 3 p.m. and 10 p.m. to learn more.