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Racial Equity, Health of Mothers and Newborns Drives Early Childhood Summit Discussion

ECAP Health panelists

Panelists from left to right: Dr. Elizabeth Tilson, Keisha L. Bentley Edwards, Sarah Verbeist and Heather Jernigan Garrity

March 1, 2019 – Better supporting women before and after they give birth can help improve the health of babies in North Carolina. That was the focus of the first of three panel discussions at the North Carolina Early Childhood Summit on Feb. 27, as part of the launch of the North Carolina Early Childhood Action Plan.

The plan outlines a cohesive vision, sets benchmarks for impact by the year 2025, and establishes shared stakeholder accountability to achieve statewide goals for young children from birth through age 8.

A panel discussed how to make sure North Carolina babies are healthy, with panelists sharing their expertise and the work they are engaged in to help improve the health of mothers and children in North Carolina.

North Carolina’s infant mortality rate is 7.2 deaths per 1,000 live births, compared to a national average of 5.9. Outcomes for minority populations are much worse — the Early Childhood Action Plan prioritizes reducing disparities between African American and white birth outcomes in North Carolina.

“African-American babies die at 2.5 times the rate of white babies within the first year of their life in North Carolina. This is just not acceptable,” said Dr. Elizabeth Tilson, State Health Director and Chief Medical Officer for DHHS, who facilitated the panel.

More than 9 percent of North Carolina babies are born at a low birth weight, compared to a national average of 8.2 percent. Malnutrition impedes brain development and learning in children, and often leads to poor emotional and behavioral health.

“Access to proper nutrition, along with high quality health care and preventive services including immunization is incredibly important,” said Tilson.

Closing health insurance coverage gaps could help increase the number of healthy births and start children on-track to healthy development in their early years, panelists said. Improving access to insurance ensures that children receive high-quality health care including age-appropriate vaccinations and other preventive services — connecting to the plan’s second goal on increasing access to preventive health services.

Keisha L. Bentley Edwards emphasized the importance of addressing the social determinants of health to decrease racial disparities and improve birth and early childhood outcomes.

“For black women – income, education and age are not the strongest indicators of positive birth outcomes, said Edwards, Associate Director of Research at the Cook Center on Social Equity and an assistant professor of medicine at Duke University. “There are underlying social issues such as poverty and domestic violence that affect the health and safety of the mother and child that must be addressed.”

Edwards said racial disparities must be addressed as a systemic issue.

“We must talk about race as an institutional structure and how it affects minorities in their educational experience, and throughout their lives,” she said.

Edwards emphasized that minorities in all communities need access to good employment with solid insurance, and when this is not available, support from social safety nets provided by government programs. She pointed to home visitation programs that assist with breastfeeding and help ensure a healthy environment for the mother and child as being particularly effective in minority populations.

“We need to make sure that resources are not concentrated in cities but are reaching black women and families who live in rural areas as well,” she said.

Heather Jernigan Garrity, program manager for Healthy Beginnings and Parents as Teachers Coalition for Families in Lee County, shared how their home visiting program provides critical support for families during a stressful time.

“Our case workers are conducting home visits with new and expecting mothers to help them make healthy decisions related to nutrition and exercise and, if needed, tobacco cessation,” she said.

Garrity said families are in the program until the child reaches age 2.

“We work with parents throughout this period of early childhood to help them understand their child’s development as they grow and the importance of proper nutrition and well-child visits with their pediatrician,” she said.

Sarah Verbiest emphasized the importance of making perinatal support services broadly accessible to all women and families.

“There are times when all women need help,” said Verbiest, director of the Jordan Institute for Families and executive director at University of North Carolina’s Center for Maternal and Infant Health. “It is a physical feat to carry, give birth to and care for a baby; we need to do more to prepare women and families for the marathon of activities and experiences to come after the birth of a baby.”

DHHS worked with over 350 stakeholders from across the state to develop the Early Childhood Action Plan, including the Governor’s Early Childhood Advisory Council (ECAC). More than 1,500 people provided feedback on the plan, giving valuable input as the plan was drafted.

The plan outlines a cohesive vision, sets benchmarks for impact by the year 2025, and establishes shared stakeholder accountability to achieve statewide goals for young children from birth through age 8.

UNC-TV broadcast the panel's discussion and a recording is available.

Scott Coleman