The need for such training seems more acute given the devolution of programs to the states. While many public health initiatives focus on the need for community-based interventions and coalition building, few include a component related to leadership development and leadership effectiveness for the 21 st century. The Maternal and Child Health Community Leadership Institute is designed to assist state MCH directors and state APHA affiliates in collaboration with community and civic leaders to achieve the Healthy People 2010 MCH objectives. The Institute offers health officials and advocates the opportunity to look at recent research on the effects of social systems, community context, social capital, and economic inequality and to examine how findings may be applied to change social systems and to enhance the well-being of women and children. Black infants are more than twice as likely to die as white infants.
Black women are twice as likely to die of pregnancy-related causes than white women.
There is also evidence of disparity among infants from other major ethnic groups. 1 Other data and analyses suggest that to achieve any further reductions in infant mortality and morbidity, the public health community, health care providers, and individuals must focus on modifying the behaviors, lifestyles, and conditions that affect birth outcomes. The conditions include those ecological or contextual factors that play important roles in influencing health and well being. While many strategies and frameworks address biologic factors, few address other contributing factors. To understand and address the underlying factors of these disparities, we must understand, in addition to biologic factors, social, economic, psychological, and environmental factors as well.