In conjunction with SIDS Awareness Month, First Candle hosted a roundtable entitled The Impact of Implicit Bias and Social Determinants on Infant Mortality, at Holy Name Medical Center in Teaneck on Tuesday.
The event focused on improving maternal health and reducing infant mortality rates among women and children.
First Candle is a national nonprofit committed to ending SIDS (sudden infant death syndrome) and other sleep-related infant deaths including accidental suffocation or strangulation in bed. They also provide bereavement support to those who have experienced a loss.
Alison Jacobson, chief executive officer of First Candle, told NJBIZ it is important to get everybody at the table – especially in New Jersey where there is a high rate of infant mortality.
“It’s not just about safe sleep it is about health disparities and racial bias. At First Candle, we have our program Straight Talk for Infancy because if we are not listening to the community and understanding their specific issues, we can’t move the needle on this.”
Jacobson said that up until about 10 years ago, starting with First Candle’s Back to Sleep campaign, there was a 50 percent reduction in SIDS.
“It then moved to the Safe to Sleep campaign where we saw more reduction but then it leveled out. What we know is that a vast majority of the cases are accidental suffocation,” said Jacobson. “But we know that by following safe sleep guidelines which is room share with the baby, not bed share and nothing in that crib. No blankets, no stuff animals and keep the baby on the back we can prevent a vast number of these deaths.”
Jacobson said that 50 percent of births happen on Medicaid. And, many of the young women who are getting pregnant don’t have any insurance and are not getting to their first prenatal visit until they are five or six months pregnant.
Low birth weight and prematurity increase the risk of SIDS by four times and once the baby is born some women are not getting the right messages.
“A lot of this is messaging is not tailored to the audience. Until we understand their social determinants, it is not going to change,” said Jacobson. “That is why with our program we are listening to them and saying what are your issues? Maybe you have housing insecurity; maybe you don’t have a place for your baby. Let’s work with you to find out how we can create a safe sleep environment.”
Dr. Payal Shah, chief OBGYN, Holy Name Medical Center, said the primary place to start is with prenatal care.
She asserted that it is really important for OBGYNs to begin the conversation there. “It is not just about taking care of the mom in pregnancy but educating them beyond as well.”
Shah noted that it is important in indigent communities to make people aware that prenatal care is important because they might not think that it is necessarily part of the problem.
Shah said that there are organizations such as First Candle and other resources available to women.
Culture also plays a strong role in what happens once the mom goes home with the child.
For instance, some mothers engage in certain behaviors or practices because a family member told them that it is the right thing to do.
“When I hear it in my office I try to convince people that that might not be the right way and they should discuss it with me or their pediatrician. Because it is family culture or habit doesn’t mean that it is good.”
Shah said that it is important to touch on these vital points during prenatal visits or regular checkups.
Because it is family culture or habit doesn’t mean that it is good.
– Dr. Payal Shah, chief OBGYN, Holy Name Medical Center
Dr. Andrew Rubenstein, co-chair, New Jersey Perinatal Quality Collaborative noted there is a rising trend of severe maternal morbidities and preventable mortalities across the country.
According to First Candle, more than 3,600 babies die annually from SIDS and other sleep-related causes, and SIDS remains the leading cause of death for babies one month to one year of age. Deaths among African American babies are twice as high as that of non-Hispanic Caucasian babies. This disparity is in line with the rate of maternal mortality.
A primary goal of First Candle is to gain insight into the systemic changes necessary to improve infant mortality rates in communities of color and address the effects of historical and structural racism and other barriers to education and support on safe sleep and maternal care for families.
New Jersey is in the bottom five among states, with an average of 37 pregnancy-related deaths for every 100,000 live births, according to the New Jersey Department of Health (DOH). That’s near twice the national average in a country that only ranks 46th in the world, according to the CDC.
According to the NJDOH, the state has the widest racial disparity in maternal health in the nation. African American women are five times more likely to die due to pregnancy complications than white women and an African American infant is three times more likely to die in his or her first year of life than a white baby.
First Lady Tammy Murphy and author Kimberly Seals Allers were honored for their advocacy work and support in addressing SIDS. Murphy was recognized specifically for her program Nurture NJ – a statewide awareness campaign that is committed to reducing infant and maternal mortality and morbidity.