Advancing Health Equity Through Public Health Policies: An Infant Vitality Surveillance Network and First Steps Program

Issue	Infant mortality, a universal indicator of a community's health, is unacceptably high in Cincinnati. Our Citywide rate is 13.3 (2006-10). Like communities accross the country, it is highly concentrated in certain neighborhoods.  In 2008 more than 50% of infant deaths occurred in 5 zip codes. In one zip code the Infant Mortality Rate (IMR) is 32.2. Solution: Every woman deserves quality care before, during and after pregnancy.  Our First Steps Infant Vitality Surveillance Network (IVSN) is a partnership connecting mothers and babies in targeted zip codes with access to health services, education, care coordination and home visitation. Overarching goal: achieve health equity in infant vitality (IMR reduction).
Setting	City of Cincinnati with emphasis on geographic target area zip codes with IMR of 10>. Target population are all women residing in the target zip codes, deliver at the participating hospitals and/or receive prenatal care at IVSN Federally Qualified Health Centers (FQHC). Hospital, FQHC, and Home Visitation Agency decision makers will benefit policy change wise.
Project	Partnership of CHD, hospitals, FQHCs, and home visitation agencies that theoretically reach out to all mothers living in double digit (10>) IMRs. Participating hospitals & home visitation agencies provide five interventions to moms residing in the target zip codes.  Interventions are: Safe Sleep, does patient have a medical home, Depression Screening, enrolled in WIC, Breast Feeding Education.
Accomplishments	Achieved city wide 9.9 IMR in 2013 - (25.5% reduction).  IMR reductions in 11 of 17 target zip codes. Two target zip codes had zero infant deaths.