Caring for 2—a federal program for mothers and infants at risk

It gives me pleasure to report on a federal health/poverty/race program that actually is meeting its goals—Caring for 2.  I’d never heard of it, but came across the name on the list of referrals we use at the Pregnancy Decision Health Center where I volunteer.

http://publichealth.columbus.gov/uploadedFiles/Public_Health/Content_Editors/Maternal_Health/Caring_for_2/Caringfor2_update_1pager_2011.pdf

Caring for 2 began in 1991 as part of Healthy Start with 15 test sites, and now has 105, two in Ohio, Columbus and Cleveland. Although I don’t believe it began as a race based program, it is now limited to African Americans, and in Columbus to specific zip codes. The mission was to reduce the high infant mortality rate; in Columbus this has certainly been successful (for those enrolled) with the infant mortality rate below the national average.

There seems to be a recent push to include fathers in the program (NHSA’s Where Dads Matter fatherhood program begun in 2007).  Who knew?  Actually the number one advantage for a poor or low income child is to have married parents. That and a job for dad, any job, will provide those parents with the opportunity to leave poverty behind.  No government program makes that kind of promise.

I can’t find anything current under Healthy Start that specifically funds promoting fatherhood, but did find a page of links.  It is mentioned in the national annual report, but is definitely a step child added during the Bush years. http://fatherhood.gov/for-programs/federal-programs-and-resources

California’s program includes a piece specifically for “dads” but marriage doesn’t seem to be a part of that. In fact, it’s not even mentioned as the biggest guarantee that a child won’t grow up in poverty. http://www.healthycal.org/archives/10425

Here is a state by state update on what is happening. Despite the success rate, or perhaps because of it, I was disappointed to read how some programs are being watered down with other issues, like fighting racism, because there are so many other avenues for that, and success has been dramatic by focusing on health and coordinating community resources already available.

http://www.nationalhealthystart.org/site/assets/docs/NHSA_SavingBabiesPub_2ndED.pdf

Healthy Start is currently funded at just under $105 million and authorized through 2013. Healthy Start was first established as a pilot program by President George H.W. Bush in 1991. The last reauthorization of the program passed Congress in 2008 and was signed into law by President George W. Bush on October 3, 2008. The fatherhood component was added under GW Bush.

Black infant death rate in Ohio—Columbus Dispatch

It’s high.  Infant mortality applies to age up to one year.  If they counted pre-born black infants who are killed in abortion, the figure would be much, much higher.

I hope someone at the Dispatch digs a little deeper and looks at something beside race in today's story about high infant mortality among blacks in Ohio. For instance, adjust for marriage, education, employment, age, entitlement programs, etc. Instead, someone will ask for more government money.

http://www.dispatch.com/content/stories/local/2012/11/29/black-infant-deaths-worst-of-bad-news.html

And much of the solution, they said, will come from officials who don’t work in the fields of maternal and child health, but rather in local, state and federal government; housing; education and early-childhood education; and those focused on family well-being who haven’t traditionally focused on birth outcomes.

For example, Mario Drummonds, executive director and CEO of the Northern Manhattan Perinatal Partnership in New York, cited new housing as making a positive difference in infant mortality by providing a better environment in which to raise infants who suffer from asthma.

The Madison Miracle

As you probably know if you live in the midwest, Madison, Wisconsin is our most left leaning city. Detractors sometimes called it the "People's Republic of Madison," or "The left coast of the midwest" and it is the home of "The Progressive." I've only been there once or twice, and so I'm just passing along rumors about its reputation. Personal observation here. A recent issue of JAMA had an interesting CDC study on Dane County (Madison) on the the Infant Mortality Gap. JAMA itself is editorially a very liberal journal (with almost all the advertising from pharmaceutical companies), so it's important to remember that "gap" is the key word here--it's what liberals care most about--especially academicians and researchers paid by government grants. Never the individual, or even the group, but the GAP. It doesn't matter one bit if a second generation Hispanic family lives in a home with 3 bedrooms, 2 baths, 3 color TV sets, and a 2 car garage, because if a 5th generation white family has 6 bedrooms, 3.5 baths, 4 HDTV sets, and a 3 car garage, you have a terrible gap problem that only demonstrates the evils of free market capitalism.

Well, somehow, the Infant Mortality Gap has disappeared in Dane County, and they can't figure out why--obviously, someone has miscalculated, because this just can't happen, not even in liberal Madison. I was a little puzzled too, reading through the stats

Of a population of 472,000 in 2007, only 4.8% is black

black women giving birth in Dane County have a median household income of $28,103 compared to white women giving birth with a household income of $50,927

77% of the black women giving birth are unmarried, compared to 19% of the white women (That ought to clear up the household income problem, right? Two incomes instead of one--duh!)

71% of the black women giving birth in Dane County have a high school diploma or less versus 21% of the white women (This is a very awkward way to say the white women are more likely to be college educated--the University of Wisconsin is located there.)

and

62% of the black mothers are on Medicaid, but only 13% of the white mothers in Dane County.

Despite poverty ($28,103 is called poverty in this study), out of wedlock births, and incomplete education, the gap has disappeared. So they're looking for all sorts of possibilities since 2002, the first year of the decline--increase in graduation rate, reduction in smoking, improved prenatal care, better record keeping, broader health insurance coverage, targeted public health programs, better neighborhood safety, advocacy for black women and their families and other variables. For now it will remain a mystery, because anything good that happened during the Bush Administration will have to be debunked, especially in Madison.