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Topics > Reducing Health Disparities Initiative > What We Are Doing > Low Birth Weight An African-American Health Disparity in the U.S.

Low Birth Weight An African-American Health Disparity in the U.S.

Dawn Dailey, Cheri Pies and Itika Greene (from left to right)

This month's health disparity topic is low birth weight babies. African-American women living in Contra Costa County are almost twice as likely to give birth to low birth weight infants than the county population as a whole.

Low birth weight infants, who are born weighing less than 5 lbs. 8 oz., are at high risk of illness, death and lasting health problems. A large percentage of infant deaths are linked to the babies being born too early and too small, according to Public Health Nurse Dawn Dailey, who manages our Fetal Infant Mortality Review (FIMR) program. FIMR looks for trends in infant deaths to identify gaps in services.

Many barriers to reducing this disparity exist, including poverty, racism, transportation issues and distrust of the system. Low birth weight itself among African-Americans is a phenomenon that is specifi cally unique to being born in the U.S. It is not a genetic or biological issue but a result of signifi cant experiences among African-Americans living in the United States, said Itika Greene, Perinatal Services Coordinator in Public Health's Family, Maternal and Child Health Programs (FMCH).

To address the issue, protocol development sessions and intensive trainings - particularly with perinatal providers at Contra Costa Regional Medical Center (CCRMC) and the Health Centers (HCs) - have been held and are updated periodically. "This issue of low birth weight infants is a high priority for the hospital and health centers," said Jeff Smith, Executive Director of CCRMC/HCs.

CCHS divisions and programs are tackling the major causes of low birth weight - smoking, perinatal substance abuse, domestic violence and periodontal disease - as well as the more complex issues such as stress, environment and access to health care that can affect birth outcomes, said Cheri Pies, Director of FMCH. "We're trying to close the Black/White gap in birth outcomes by addressing both the obvious causes and the underlying issues," Cheri said.

FMCH and our Community Wellness & Prevention Program (CW&PP), with funding from First 5 Contra Costa, are Promoting Smoke-Free Families by educating providers on how to better identify patients who are at risk for smoking or secondhand smoke and then linking these women with services to help them quite smoking or decrease their children's or their own exposure to secondhand smoke. The Perinatal Substance Abuse Partnership (PSAP) is working to address issues of drug and alcohol use by pregnant women and women with children.

PSAP is an integrated, coordinated countywide partnership that includes representatives from Public Health, Mental Health, Alcohol and Other Drugs Services, and CCRMC/HCs, as well as Children and Family Services, Probation, Community Services, and community-based organizations.

CCHS also is reaching out to African-American women through the Black Infant Health (BIH) Program, which is run by the Perinatal Council and provides home-based case management to pregnant African-American women, including education and resources to improve birth outcomes. Even our Dental Program is involved by working to improve oral health for pregnant women since oral infections can cause low birth weight.

"This disparity is not new," Itika said. "FMCH programs have been doing outreach, providing case management and increasing access to comprehensive prenatal care for many years in a concerted effort to improve the birth weights of African-American infants. We've made some progress over the years, but there could be a lot more done." The latest research suggests that efforts should focus on reaching women before a pregnancy or following a pregnancy to assess risk, build strengths and improve overall health prior to pregnancy.

FMCH is seeking grant funds to test this approach. Because of the complexity of low birth weight, reducing low birth weight rates in African-American infants will require complementary interventions that are sustained over a signifi cant period of time.

Send feedback about this story to Kate Fowlie at

Content provided by the Reducing Health Disparities Initiative.

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