Partners for Healthier Babies
Over 40% of pregnant women in La Porte County receive little, late, or no prenatal care. Babies born to mothers who do not receive prenatal care are three times more likely to die than those born to mothers who do get care. La Porte County’s infant mortality and preterm birth rates are higher than the state of Indiana and the top U.S. performers. To address high rates of infant death, low birth weight babies and preterm births in La Porte County, Healthcare Foundation of La Porte (HFL) established the Partners for Healthier Babies Council in 2019.
This council is a collaboration between medical providers, public health agencies, nonprofit organizations, parents, and community members. Partners for Healthier Babies will address the social, behavioral, and health risk factors that contribute to infant mortality, preterm birth, lack of prenatal care, and low birthweight to make a positive impact on birth outcomes.
Using a results-based framework to establish impactful strategies to improve maternal and child health, HFL is actively convening social service agencies, and key community and state leaders in the planning, strategizing, and execution of infant mortality reduction strategies. Additionally, HFL seeks to improve the quality and expand the reach of public awareness and education related to prenatal health issues, particularly preventative health habits for pregnant women and their families.
Partners for Healthier Babies (PHB) Council is a 25+ member, county-wide collaboration of community partners working together to deliver healthier moms and babies. Multiple agencies and sectors that serve moms, babies, and families make up the Council membership, and together are effective in bringing about change in areas affecting infant mortality. In addition, members bring resources, expertise, and relationships to the table to help plan, strategize, and implement a county-wide action plan.
The Council has emerged as a lead organization in La Porte County to solve the complex issue of infant mortality. Low birth weight and preterm birth are key risk indicators/factors and are influenced by multiple factors. Early prenatal care (care in the first trimester of a pregnancy) allows women and their healthcare providers to identify, treat. monitor, and influence health issues and health-compromising behaviors that can be damaging during the initial stages of fetal development. Increasing the number of women who receive early prenatal care can improve birth outcomes for mom and baby.
Outcomes are generated at the council level and workgroup level and include:
Council Level Outcomes include:
- Increased connection and familiarity with diverse peers.
- Strengthened our data access and service provider mapping.
- Increased interest & enthusiasm for, engagement in, and diversity of the PHB Council.
Workgroup Level Outcomes include:
- Increased awareness of existing resources in the county.
- Explored learning agendas – causes (story behind the data) and solutions (what works).
- Connected and engaged with leaders of color.
- Focused strategies on underserved populations.
- Increased knowledge of, and focused strategies on, evidence-based solutions.
- Strengthened our data access.
A listing of PHB Council members can be found here.
Local Priority: Healthy Children
Children’s health is inseparable from Healthcare Foundation of La Porte’s (HFL) mission of empowering our residents to live healthy and well. The lifelong benefits of prenatal, infant, and child wellness have led us to identify Healthy Children as an HFL Strategic Focus Area.
The PHB Council researched and collected data on indicators related to HFL’s Healthy Children strategic priority. These indicators and associated county, state and national values are shown below.
Risk Factors for Infant Mortality Rate
Infant Mortality stems from multiple factors that originate prior to pregnancy or delivery. These include:
- Labor & Delivery
- Birth Outcomes
A women’s health prior to getting pregnant (preconception) is critical to a healthy pregnancy and a healthy baby. These risk factors that can lead to poor outcomes for baby and mom include poor nutrition, obesity, substance use, stress, and poor mental health.
Risk factors during include minimal weight or excessive weight gain, lack of social support, continued substance use, extremes of maternal age (very young vs mature age), adverse living conditions (food insecurity, poor or no housing, and domestic violence), inadequate prenatal care, medical risk factors, and limited access to high-risk perinatal services.
Labor and delivery can bring its own challenges including mode of delivery, no plan for delivery at risk-appropriate hospital, delivery complications, lack of breastfeeding, and mother being uninsured/underinsured.
Finally, morbidities such as low and very low birth weight, preterm and very preterm, small for gestational age, post-term delivery, and congenital malformations and anomalies have shown that they can lead to fetal, newborn, and infant death.
What is the impact to infant born preterm or at a low birth weight? Researchers and health care providers are working to understand the health challenges faced by infants born preterm or at a low birth weight as a way to develop treatments for these challenges. As an example, preterm infants are at high risk for serious breathing problems as a result of their underdeveloped lungs. Treatments such as ventilators and steroids can help stabilize breathing to allow the lungs to develop more fully. In addition, studies suggest that infants born at low birth weight are at increased risk of certain adult health problems, such as diabetes, high blood pressure, and heart disease
La Porte County has made good progress from 2017 to 2019.
- Preterm births decreased from 11.8% in 2017 to 10.4% in 2019.
- Low birth weight has decreased from 9.4% and 8.1% .
- Smoking decreased from 21.6% to 18.6%.
La Porte County, Indiana and USA 2017 – 2019 Birth Statistics are shown below:
Using Results-Based Accountability (RBA) Framework to Make Measurable and Meaningful Change
Results-Based Accountability (RBA) is a disciplined, data-driven, decision-making process to help communities and organizations move from talking about problems to taking action to solve problems. RBA is being used by HFL to take measurable and meaningful change. Developed by Mark Friedman and described in his book Trying Hard is Not Good Enough, RBA is being used in all 50 United States and in more than a dozen countries around the world to create measurable change in people’s lives, communities and organizations.
It is critical to identify meaningful measures to determine the progress a community is making towards achieving community well-being. Once we identified the most meaningful measures to improve, RBA provided a step-by-step process to get from ‘ends to means’. The framework helped the PHB Council to answer these questions:
- What result are we trying to achieve?
- How are we doing, according to indicators?
- What is the story behind the curve of the baseline indicator data?
- Who are the partners who have a role to play in doing better?
- What works to do better?
- What is our action plan to do better?
The council’s strategic opportunities were selected and organized using a health outcomes by life stages approach. This approach draws attention to both individual and societal determinants that affect a woman’s and baby’s health. We recognize that specific risk factors and determinants of health vary across the life of women in child-bearing age and their infants. Preconception (before pregnancy), prenatal, perinatal and postpartum, and infant (first year of life) care allows for intervention at specific points in the continuum of the woman’s and baby’s life to reduce risk factors and promote healthy outcomes. Healthy birth outcomes and treatment of health conditions among infants can prevent death or disability, and enable children to thrive.
RBA has guided our council to investigate what works to do better by examining what programs are currently established in the county, what evidence-based programs have outcomes we are seeking, and what no-cost, low-cost solutions are available.
The Council continues to connect with leaders and members of the community, agencies in the community and state departments to impact a resolvable problem.
These resources will connect residents with comprehensive prenatal care, including prenatal nutrition education, oral health care, and mental health supports. Additional resources are available that include such topics as transportation, employment, housing, legal aid, rent and utility assistance, medical insurance, domestic violence, parenting, addiction, smoking, HIV, and among others.
Ten 2030 is the first gift given to the La Porte community by Healthcare Foundation of La Porte (HFL). Ten 2030 is an up-to-date source of population health and socioeconomic data, providing resources for community assessment, strategic planning, best practices, collaboration and advocacy. Healthy Pregnancy | Healthy Babies | Healthy Families is a comprehensive resource directory of social service resources for expectant women, dads, and families in La Porte County. To access this resource, click here.
Indiana Community Connect is an innovative community-based resource directory and referral network bringing residents, state programs, and community partners together using one comprehensive and unified online platform. Click here. Web link coming soon!
My Healthy Baby is a collaboration between the Indiana Department of Health, the Indiana Family and Social Services Administration (FSSA) and the Indiana Department of Child Services (DCS). Click here.