For several years, Jill Thompson has been showing people through the streets in poor, racially segregated neighborhoods in north St. Louis and North County, pointing to the barriers to healthy pregnancies and raising young children.
From her SUV she notes the crumbling sidewalks, shuttered factories full of toxins, the abandoned houses and the ones that look abandoned but still house families.
In the Ville — once a thriving African-American middle-class neighborhood — there’s a dearth of retail, including supermarkets with fresh produce. A few miles northwest, in St. Louis County, the bus stops are spaced far apart on major roadways, some with sidewalks barely wide enough for a stroller.
Thompson works for Generate Health, a regional group promoting better maternal and infant health. She gives these tours in areas notorious for the high rate of babies dying each year before their first birthday to explain the challenges of keeping infants and expectant moms healthy: fear of violence, a dearth of easy, reliable transportation, poor access to health care, and few safe places to exercise and play.
And she’s spoken of the consequences of living in poverty, how a local study suggests that half of low-income mothers suffer from depression — and how “toxic stress” contributes to preterm labor.
A recent study commissioned by Generate Health found disturbing racial trends within infant mortality. African-American babies are three times as likely to die as white babies in St. Louis. Black women in Missouri are nearly 50 percent more likely to have a preterm baby than any other group, regardless of socioeconomic status.
The study further found the majority of the region’s infant deaths occurred in the first month of life and correlated with significant incidents of high blood pressure among African-American mothers during pregnancy, nearly tripling their risk for babies with lower birth weights.
And yet despite these pregnancy risks, more than a fifth of black mothers received inadequate prenatal care compared to just 5 percent of white mothers. Black mothers were 137 percent more likely to lose a baby in the first month of life than white mothers.
Generate Health, the new name for the Maternal, Child and Family Health Coalition, has been sounding the alarms for years. But last year, agency leaders upped their game.
With funding from the Missouri Foundation for Health, they announced a new campaign to combat infant mortality called Flourish, and they are focusing heavily on the racial and social health disparities affecting African-Americans.
The group launched the effort with a simple fact: the number of babies that die each year in the region amounts to 15 lost kindergarten classrooms.
“Imagine the lost potential,” Thompson said during a recent car tour. “Imagine the future leaders, the artists, the minds we lose each year.”
Now a year in, Flourish has is acting on a new study of infant deaths commissioned by Missouri Foundation of Health. It has conducted a year’s worth of community meetings to hear the voices and needs of mothers and children in vulnerable neighborhoods.
The next step is for volunteers and community agencies to join forces on five initiatives to lessen infant mortality.
A call to act
Last week, at an event at New Northside Missionary Baptist Church’s conference center on Goodfellow Boulevard, Flourish unveiled a call to action. At the end of the meeting about 100 attendees locked arms in a circle and pledged to help solve these issues and recruit others.
Among the initiatives is a future public information campaign promoting infant safe-sleep practices among African-American families, in part, because Generate Health’s study found black infants in the region are four times more likely than white babies to succumb to sudden unexpected infant death.
In the past three years alone, 48 babies in St. Louis died under these circumstances. Eight out of 10 of those deaths were caused by unsafe sleep conditions, which included sleeping with a baby in a bed.
“It’s very good it’s getting the attention it needs,” said Lori Behrens, executive director of SIDS Resources in St. Louis who is working on the Flourish action team on unsafe sleep. “I’m glad that we made their top five.”
Other initiatives will deal with improving transportation; helping with maternal stress, depression and drug addiction; enhancing health care access; and helping moms better navigate the health and support systems already in place.
During last week’s unveiling, participants used Post-It notes to comment on each action area. For infant sleep deaths, one participant warned that mothers without heat or poor insulation in their homes unwittingly take babies into their beds with them in winter to protect them.
Another suggested Uber or another ride-share venture could be engaged to better help moms make necessary appointments. Others spoke of the grief of a losing a child and how sadness can pervade homes and neighborhoods because of it.
Bracing for change
Nicollette Mayo lost her daughter Jaz’myn at 7 weeks when her healthy daughter stopped breathing while napping. It happened during Mayo’s first day back at work, and though the mom wanted to stay home longer with her daughter, she had no paid maternity leave. In the aftermath, she fell into a deep depression and stopped working
“I have met so many mothers during this process who have lost children, and I just think it’s horrible. Anything we can do from giving out fliers to training on safe sleep would be great,” said Mayo, who attended last week’s meeting.
Flourish announced its action plan amid uncertainty over resources. Two years ago the federal government cut funding for Generate Health’s Healthy Start program which sent nurses into homes of moms with children up to age 2 — a program that had been supported by $7.1 million in federal funding. At this point, there are no plans to reinstate that program locally.
Generate Health is also bracing for anticipated policy changes in the Donald Trump presidency. Officials worry about Medicaid coverage and access shrinking, leaving more mothers without prenatal health care and early-infant health interventions. And they worry that access to birth control will be significantly curbed.
Kendra Copanas, executive director of Generate Health, said the five initiatives could focus on local strategies and resources — ventures and new ideas that can be done outside of traditional federal and state government support, though that is certainly welcome.
And yet, despite current uncertainties, Flourish workers are looking forward with hope and resolve.
“The thing is, the more we know, the more we are able to get ahead,” Mayo said.