Reducing Inequities in Birth Outcomes in North Carolina: Developing an Actionable Strategic Plan: Community Stakeholder Focus Group Research
Creators: name: Gurske, Kendall
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2012

description: In North Carolina, infant mortality and perinatal related conditions account for over 67% of all child deaths. The infant mortality rate for African American infants (12.6 per 1,000 live births) is more than twice that of Caucasian infants (5.4 per 1,000 live births). African American babies are also disproportionately low birth weight (14% of African American infants were less than 2500 grams in 2011 compared to 7.5% of White infants) and pre-term (17% of African American infants were less than 37 weeks completed gestation compared to 11.2% of White infants). The causes of infant mortality are complex and extend beyond the traditional biomedical model to include factors related to family and community systems and social and economic inequalities. Public health efforts to close the racial and ethnic gap in birth outcomes have traditionally focused on increasing access to prenatal care, and while the gap has been closing, progress has been slow. In light of this, Lu et al proposed a life course approach to reducing disparities which addresses the needs of African American women for quality healthcare across the lifespan, family and community systems that may influence the health of pregnant women, families, and communities, and the social and economic inequities that underlie health disparities—the 12-­Point Plan to Reduce the Inequities in Birth Outcomes (Appendix A). This focus group research project was undertaken as a component of the ongoing North Carolina Equity in Birth Outcomes Council’s overarching goal to bring together leaders from different sectors to develop a strategic action plan for the state of North Carolina to eliminate racial and ethnic disparities in birth outcomes. Other components of this work included approximately 18 key informant interviews conducted with leaders in public health, education, and community and economic development across the state, a series of expert presentations, and feedback from the Leadership Team and larger Advisory Council. All of this work has been funded by an Academic-Community Partnership grant (U13) from the National Institutes of Health and Development. The work was approved by the University of North Carolina and Chapel Hill Institutional Review Board and was considered exempt as we didn’t collect personal information about participants in the focus groups. Quantitative data alone is insufficient to understand the causes behind the racial and ethnic gap in infant mortality and other birth outcomes in our state. In order to obtain a clear picture of the interventions needed to close this gap, it is necessary to understand the stories behind the quantitative data. Starting in August of 2012, we carried out a series of focus groups with the purpose of gathering ideas and opinions of key stakeholders regarding the actions that we should take in North Carolina to address inequities in birth outcomes. The focus groups were exploratory in nature with the hope that they could suggest avenues for further research. Questions were based on the 12-­Point Plan to Reduce Inequities in Birth Outcomes.