Project Grant H4953000

HEALTHY START INITIATIVE-ELIMINATING RACIAL/ETHNIC DISPARITIES - MATERNAL AND INFANT MORTALITY RATES HAVE STEADILY INCREASED IN HARRIS COUNTY SINCE 2016, REPRESENTING AN ALARMING TREND FOR THE HEALTH AND WELL-BEING OF PREGNANT INDIVIDUALS AND THEIR NEWBORNS IN THE NATION'S THIRD-MOST POPULOUS COUNTY. ACCORDING TO CDC WONDER DATA FROM 2016 TO 2020, HARRIS COUNTY HAS A HIGHER PREGNANCY-RELATED MORTALITY RATE (36.1) THAN BOTH TEXAS (33.5) AND THE U.S. (30.6) PER 100,000 LIVE BIRTHS. IN FACT, HARRIS COUNTY ACCOUNTS FOR NEARLY 20 PERCENT OF TEXAS' PREGNANCY-RELATED DEATHS - THE LARGEST SHARE BY ANY TEXAS COUNTY. THE INFANT MORTALITY RATE (IMR) FOR HARRIS COUNTY (6.0) LIKEWISE EXCEEDS THE STATE (5.9) AND NATIONAL (5.7) RATES. THESE NUMBERS ARE FURTHER EXACERBATED IN VULNERABLE COMMUNITIES, WITH THE IMR EXCEEDING 10 PER 1,000 BIRTHS IN SOME ZIP CODES. THESE TRENDS EXIST DESPITE HARRIS COUNTY BEING HOME TO THE WORLD'S LARGEST MEDICAL CENTER, AS BARRIERS LIKE ACCESS TO CARE, LACK OF INSURANCE, LIMITED ACCESS TO NUTRITIOUS FOODS, INADEQUATE TRANSPORTATION, AND OTHER SYSTEMIC CHALLENGES NEGATIVELY IMPACT HEALTH OUTCOMES FOR PREGNANT INDIVIDUALS AND INFANTS. CONCERNED WITH THE INCREASES IN MATERNAL AND INFANT DEATHS ACROSS THE COUNTY, THE HARRIS COUNTY COMMISSIONERS COURT PRIORITIZED REDUCING INFANT AND MATERNAL MORTALITY BY EARMARKING MILLIONS OF DOLLARS TO FORM THE MATERNAL AND CHILD HEALTH PROGRAM AND THE ACCESS (ACCESSING COORDINATED CARE AND EMPOWERING SELF SUFFICIENCY) HARRIS COUNTY PROGRAM. BOTH PROGRAMS WORK COLLABORATIVELY TO PROVIDE INTENSIVE HOME VISITATION AND OTHER WRAPAROUND SERVICES THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH USING EVIDENCE-BASED CURRICULA, CASE MANAGEMENT, AND CARE NAVIGATION ACROSS ALL SAFETY-NET SERVICE PROVIDERS TO ELIMINATE THE BARRIERS OF SILOED SERVICES AND SUPPORT. THE HEALTHY START INITIATIVE - ELIMINATING BARRIERS IN PERINATAL HEALTH PROGRAM WILL STRENGTHEN THESE EFFORTS TO DECREASE THE RISE IN PREGNANCY-RELATED DEATHS IN HARRIS COUNTY. WITH SUPPORT FROM THIS GRANT PROG RAM, HARRIS COUNTY PUBLIC HEALTH (HCPH) WILL EXPAND THE HOLISTIC, COORDINATED CARE APPROACH TO TARGET AT-RISK BIRTHING PERSONS IN VULNERABLE COMMUNITIES EXPERIENCING HIGH INFANT OR PREGNANCY-RELATED DEATHS AND POOR PERINATAL OUTCOMES. THE PROPOSED SERVICE AREA INCLUDES 14 ZIP CODES WITH THE HIGHEST IMR IN HARRIS COUNTY. HCPH WILL EXPAND THE MATERNAL AND CHILD HEALTH AND ACCESS PROGRAMS TO IMPLEMENT STRATEGIES AND ACTIVITIES FOCUSED ON PROMOTING OPTIMAL MATERNAL, INFANT, CHILD, AND FAMILY HEALTH AND WELLNESS. THESE INCLUDE HEALTH PROMOTION AND EDUCATION, PREVENTIVE SCREENING SERVICES, REFERRALS AND LINKAGES TO CLINICAL CARE AND SUPPORT SERVICES, NAVIGATION SUPPORT, AND CASE MANAGEMENT/CARE COORDINATION. ONE-ON-ONE HOME VISITATION WILL BE A CORE SERVICE AVAILABLE TO ALL HEALTHY START PARTICIPANTS. THE HEALTHY START INITIATIVE WILL ALSO ALLOW HCPH TO EXPAND GROUP-BASED HEALTH AND PARENTING EDUCATION CLASSES, INCREASE ACCESS TO PREVENTIVE HEALTH SERVICES, AND OFFER BEHAVIORAL HEALTH CARE TO PREGNANT INDIVIDUALS. HCPH ALSO HAS DIETICIANS AND LACTATION CONSULTANTS READILY AVAILABLE TO SUPPORT MOTHERS AND INFANTS. FINALLY, HCPH WILL CONVENE A COMMUNITY CONSORTIUM OF MATERNAL AND CHILD HEALTH SUBJECT-MATTER EXPERTS ACROSS HARRIS COUNTY TO DEVELOP AND IMPLEMENT A PLAN TO ADDRESS SOCIAL DETERMINANTS OF HEALTH THAT ADVERSELY IMPACT PERINATAL HEALTH OUTCOMES. THE CONSORTIUM WILL BUILD UPON PREVIOUS COMMUNITY ENGAGEMENT EFFORTS SUCH AS OUR 2022 BLACK MATERNAL AND INFANT MORTALITY SUMMIT AND A NATIONAL CONFERENCE WE HOSTED IN 2023 ON BEST PRACTICES IN MATERNAL HEALTH CARE. HCPH IS ALSO DEVELOPING A MATERNAL HEALTH BILL OF RIGHTS IN COLLABORATION WITH LOCAL AND NATIONAL EXPERTS TO OUTLINE THE HEALTH CARE ENTITLEMENTS OF BIRTHING PERSONS DURING PREGNANCY. COMBINED WITH THE KNOWLEDGE AND MOMENTUM GENERATED BY THESE INITIATIVES, THE COMMUNITY CONSORTIUM WILL FURTHER STRENGTHEN OUR COMMITMENT TO REDUCING DISPARITIES AND DECREASING MATERNAL AND INFANT MORTALITY RATES IN HARRIS COU NTY.