Experts believe that social, economic and racial stresses play an important role in poor birth outcomes—babies born too early and too small—for African-American women. Within a culturally affirming environment and honoring the unique history of African-American women, Black Infant Health (BIH) aims to help women have healthy babies. Participants learn proven strategies to reduce stress and develop life skills. This is accomplished through a group-based approach with complimentary case management.
The group experience builds social support, which helps buffer the negative effects of stress and empowers participants to make positive choices in their life. Weekly group sessions help women access their own strengths and set health-promoting goals for themselves and their babies. Ultimately, this approach will impact not only themselves, but future generations of African-American women, infants and families.
Black Infant Health Program Contact Info & Hours
1845 N. Fair Oaks Ave
Pasadena, CA 91103
Phone: (626) 744-6155
Monday-Thursday 8:00am – 5:30pm
Friday 8:00am – 4:30pm
To make an appointment, please call (626) 744-6155
In 1989, with the passage of Senate Bill (SB) 165, Budget Act of 1989 (Alquist, Chapter 93, Statutes of 1988), California began to more aggressively address the challenge of improving the health of African American women, infants, and children by promoting health and health care during the prenatal and postpartum periods and providing services in a supportive and culturally-competent manner. Originally a pilot project in four sites, the BIH Program has expanded its reach to 17 local health jurisdictions (LHJ) where over 90 percent of all African-American births occur in California (BSMF, 2008).The primary focus of the original BIH Program, established in 1989, was getting participants into prenatal care.
In 1993, CDPH/MCAH contracted with the University of Southern California (USC) to conduct an assessment of the BIH Program. The assessment revealed that the participants served had multiple, complex needs beyond the scope of the services being provided by the program. Implementation of a standardized statewide “best practice” model was recommended based on findings from the assessment. It was recommended that the standardized services should encourage advocacy and empowerment skills and include outreach, case management, social support and empowerment, prevention, health behavior modification and male parenting. Based on the findings in the USC assessment, six BIH models were developed to address the various needs of the participants and the fathers of the babies in 1995. These models were:
- Prenatal Care Outreach and Care Coordination
- Comprehensive Case Management
- Social Support and Empowerment
- The Role of Men
- Health Behavior Modification
In 2006, CDPH/MCAH commissioned UCSF/ Center on Social Disparities in Health (CSDH) to conduct an assessment of the BIH Program. The Black Infant Health Program: Comprehensive Assessment Report and Recommendations found that there is no definitive scientific evidence about how to decrease racial disparities in birth outcomes, but solely getting prenatal care will not close the gap. Interventions that have shown great promise are group-based prenatal care emphasizing social support and empowerment yielding promising results in one recent study. There is mixed evidence regarding the effect of social support on birth outcomes, but positive effects have been demonstrated on a variety of maternal health outcomes across the life course, and social support has been shown to buffer against stress. Effects of empowerment on birth outcomes have not been tested but empowerment has improved a wide array of health behaviors and health-related outcomes in the health promotion literature.
Based on these findings, the assessment recommended a single core model for the BIH program that addresses health promotion, social support, empowerment, and health education throughout a woman’s pregnancy and early parenting that builds upon promising models. The assessment concluded that standardizing interventions across sites would help the program’s long-term sustainability by generating information about program impact that is both scientifically sound and compelling to policy-makers, and that bringing program content in line with current scientific knowledge—e.g., regarding the importance of social support and empowerment in health behavior change and of social and economic factors in health outcomes—would make the BIH Program more effective in meeting its participants’ needs and achieving program objectives.
Building on successful components of existing BIH Program models and incorporating other promising practices, the resulting model supplements recommended medical care outside of BIH with participants-centered social services–integrating prenatal, postpartum, parenting and infant health education and promotion with social support and empowerment into one standardized model that will be implemented at all sites.
To better meet the health-related needs of pregnant and postpartum African American women who are the target population for BIH, CDPH/MCAH is implementing a standardized BIH Program that features both: (1) a group intervention designed to encourage empowerment and social support in the context of a life course perspective; and (2) enhanced social service case management to link participants with needed community and health-related services. The goal of the program is to provide services in a culturally-relevant manner that respects participants’ beliefs and cultural values while promoting overall health and wellness, and recognizing that women’s health and health related behaviors are shaped by non-medical factors (e.g., the effects of stress related to limited social and economic resources as well as racism and discrimination).
The BIH Program has been developed to address these social determinants of health in ways that are relevant, culturally affirming and empowering to participants.
The BIH program provides culturally appropriate services that respect the participant’s values and beliefs. The program includes empowerment-focused group support services and case management to improve the health and social conditions for African-American women and their families. Activities draw from promising practices and are based on the findings of a 2010 comprehensive assessment of the BIH model.
BIH groups offer fun and interesting activities that will help you:
- Gain support from other women
- Learn what to expect when pregnant
- Nurture and bond with your baby
- Get infant care and feeding tips
- Manage and reduce stress
BIH provides 10 prenatal and 10 post- partum sessions designed to empower and support participants. Group sessions are offered in a culturally sensitive setting that respects participant values and beliefs. Attendees interact with other mothers and women who are pregnant. The sessions offer engaging activities from a women’s health perspective that explore pregnancy and parenting.
- Cultural Heritage as a Source of Pride
- Healthy Pregnancy, Labor & Delivery
- Nurturing Ourselves & Our Babies
- Prenatal, Postnatal & Newborn Care
- Stress Management
- Healthy Relationships
- Celebrating Our Families
Complementary Life Planning:
BIH acts on the assumption that participants have the strength and resilience to improve their health for themselves and their families. Through Life Planning, participants receive guidance and referrals on a range of topics, including health insurance application assistance and family planning counseling. Women become empowered to make positive choices in their life.
BIH Intervention Purpose & Rationale
African-American mothers and babies continue to face challenges to their optimal health and well- being. The California Black Infant Health (BIH) program is intended to address the problem of poor birth outcomes and health disparities that affect African-American women and their babies. BIH aims to improve health among African-American mothers and babies and to reduce the Black: White disparities in maternal and infant health by helping women become empowered to make healthy choices for themselves, their families and their communities.
Within a culturally affirming environment and honoring the unique history of African-American women, the BIH program uses a group-based approach with complementary participant-centered case management to help pregnant and parenting women develop life skills, set and attain health goals, learn strategies for managing stress and build social support. Each BIH participant attends weekly group sessions and works individually with BIH staff to set and make progress toward meeting personal goals, to connect with other community and social services to meet her needs, and to develop a longer-term life plan that can guide her continued progress after BIH.
The health of African-American mothers and infants can be improved and health disparities reduced through an empowerment-based approach that focuses on strengthening life skills, building resilience, reducing/managing stress, and promoting healthy behaviors and relationships to help women create healthier lives for themselves and their children.
Addressing stress among African-American women:
- including stress due to experiences of racial discrimination, trans-generational poverty, and associated powerlessness and lack of self-esteem
- is crucial to reducing the Black/White disparities in maternal and infant health. When Black women become empowered with skills to help them man- age and reduce stress in their lives, they are more likely to be healthy, have healthy babies, and raise healthy children.Having more social support can also help them and their families become healthier, in part by buffering the health-harming effects of stress and by increasing access to health-promoting resources.
The BIH intervention builds on the following evidence-informed assumptions:
- Group approaches are more effective than one-on-one approaches in accomplishing behavior change
- Most pregnant African-American women can participate in and benefit from groups when those groups are accessible, and effectively and enthusiastically facilitated
African American Health Disparities
Did you know:
- Approximately one in seven African American babies in California are born too early or too small.
- African American babies are more than twice as likely as White babies to die before their first birthdays.
- African American women are much more likely than White women to die of pregnancy-related complications.
The reasons for these health disparities are complex and cannot be fully explained by differences in underlying medical conditions or behaviors like smoking. In fact, many experts believe that aspects of social disadvantage—including poverty, lack of social support, and racial discrimination—are important contributors to the increased risks of poor maternal and infant outcomes among African Americans. Current scientific understanding suggests that experiencing these kinds of stressful conditions not only during pregnancy, but throughout life can have dramatic adverse effects on a woman’s own health and that of her baby.
Unfortunately, over 23,000 infants died in the United States in 2014. The loss of a baby remains a sad reality for many families and takes a serious toll on the health and well-being of families, as well as the nation.
The death of a baby before his or her first birthday is called infant mortality. The infant mortality rate is an estimate of the number of infant deaths for every 1,000 live births. This rate is often used as an indicator to measure the health and well-being of a nation, because factors affecting the health of entire populations can also impact the mortality rate of infants. There are obvious differences in infant mortality by age, race, and ethnicity; for instance, the mortality rate for non-Hispanic black infants is more than twice that of non-Hispanic white infants.
What are the Causes?
Fortunately, most newborns grow and thrive. However, for every 1,000 babies that are born, six die during their first year. Most of these babies die as a result of—
- Birth defects(http://www.cdc.gov/ncbddd/birthdefects/facts.html)
- Preterm birth(http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm) (birth before 37 weeks gestation) and low birth weight
- Maternal complications of pregnancy(http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregcomplications.htm)
- Sudden Infant Death Syndrome(http://www.cdc.gov/sids/index.htm) (SIDS)
- Injuries (e.g., suffocation).
The top five leading causes of infant mortality together account for about 57% of all infant deaths in the United States in 2014.
- Division of Reproductive Health,
- National Center for Chronic Disease Prevention and Health Promotion
Health Disparities in the Medi-Cal Population-Infant Mortality