When Mario Drummonds yesterday urged federal officials to substantially broaden efforts to decrease the death rate for black babies, his argument rested largely on what one organization has achieved in a four-block stretch of Harlem.
There, in a single, 1,500-unit high-rise housing project, Drummonds’ North Manhattan Perinatal Partnership has led an effort that reduced the black infant mortality rate from 27.7 deaths per 1,000 live births in 1990 to 6.1 deaths in 2008. Nationwide, the infant mortality rate for blacks is about 2.5 times that of white infants.
“Our hypothesis was this: If we can make an impact in the St. Nicholas Houses, we could make a dent in the infant mortality rate for all of Harlem,” said Drummonds, the partnership’s CEO, a social worker who also holds an MBA. “Our mission is to save babies. To save babies, we have to, in the process, improve the lives and health of mommy and daddy.”
With the involvement of other organizations, including the community-organizing, prize-winning Harlem Children’s Zone, the Partnership, which Drummonds’ began helming in 1995, started focusing on education, adequate housing and jobs as the need for good prenatal health care. The results achieved through that “life course health” model have cast Drummonds and his cohorts under a singular spotlight.
It resulted in Monday’s slated pitch session before Dr. Peter van Dyke, associate administrator for the U.S. Department of Health and Human Services Maternal and Child Health Bureau in Washington, D.C; Drummonds was soliciting van Dyke’s philosophical and financial support to build a national network of results-yielding infant mortality centers. Drummonds said he expects a preliminary response from the child health bureau next week.
Agencies such as the Alameda County Health Department in Oakland, Calif., are among those whose directors have sought advice from the New York City infant-mortality strategists. A $10-million Wisconsin campaign targeting the cities of Beloit, Kenosha, Milwaukee and Racine, where black infant mortality is three to four times higher than that of Wisconsin whites, has kicked off and is partly patterned after the Harlem project.
“We’re looking at the non-health related situations that lead to poor birth outcomes. Where we live, work, learn and play, all have an impact on our health,” said Lorraine Lathen, a global health consultant and leader of Wisconsin’s Lifecourse Initiative for Healthy Families. The University of Wisconsin at Madison’s School of Medicine and Public Health is that endeavor’s chief partner.
Its reliance on “systems change,” from improving cradle-to-grave access to health-care to reducing the social inequities and stresses that hinder positive birth outcomes, reflect what Lathen and others say is a new foray into a decades-old, off-again, on-again assault against what is a complex problem.
“It’s going to take a lot more than prenatal care. It requires us to look at…improving educational development, economic development, community development,” said Dr. Michael Lu, a UCLA medical school professor of obstetrics-gynecology and one of Drummonds’ collaborators, landing with him in locales such as those Wisconsin cities.
Recent research, Lu added, suggests good fetal health enhances the prospects for good health over a lifetime. “A host of diseases, asthma, obesity, diabetes, heart disease…actually have a fetal origin,” said Lu, also a researcher at UCLA’s Center for Healthier Children, Families, and Communities and its School of Public Health. “If you can optimize health from conception onward, you can do a lot, not only in preventing disease, but improving the overall population’s health,” Lu said.
The Harlem partnership rests on that ideal. Beyond the St. Nicholas Houses, the agency hopes to apply its “life course health” model throughout the racially gentrifying, but still predominantly black and brown neighborhoods that comprise its catchment area: Central Harlem, East Harlem, West Harlem and Washington Heights.
When Drummonds arrived in 1995 at the then 5-year-old agency — against, he said, the advice of naysayer colleagues and friends who doubted change was possible for the area — he ramped up its then staff of 18 to what now are 110 employees at the partnership’s now 13 sites. They started knocking on doors.
“We were generally rejected,” Drummonds said. “A lot of people kept their doors close. There was drug-use and crime, even though 80 to 90 percent of the people are solid, working-class. The general thought was ‘Oh, here’s another group that has the prescription to change our condition. Yeah, rah-rah.’ But I knew if we were respectful, and showed them that we meant business … that the people would come to trust us. When doors were slammed in our face, we slipped stuff under the door and said we’d be back next week. The first year or so, it was rough sledding. But that’s the reality in any community-organizing project.”
The partnership’s initiatives include its Fatherhood/Mankind Program, St. Nicholas Family Life Support Network, Managed Care Consumer Assistance Program and Comprehensive Prenatal Perinatal Service Network. Its Harlem Works job-training center, which Drummonds said trained and placed more than a 1,000 women in jobs, has not operated for the last five years, partly due to shifting priorities of public and private donors, and a hard-hit economy. That building is now rented out for private events, and reviving it as a job center is but one of the present challenges.
“What we’re finding is that more and more women are going into pregnancy obese, with chronic illnesses, developing gestational diabetes, which aren’t good odds for trying to keep a baby alive and healthy,” Drummonds said. “These are issues for urban and rural people around the nation…. We’ve still got a problem to fix.”