The Newark Community Health Centers, Inc. (NCHC), a Federally Qualified Health Center (FQHC), seeks to reduce the disproportionately high infant mortality rate (IMR) reported for Black infants nationally, by lowering the rates reported for Essex County, New Jersey, its service area. NCHC will implement its existing action plan as part of its dedication to optimizing health outcomes and reducing racial and ethnic disparities in health care. These are major priorities for NCHC as they help the agency achieve its mission of assuring the continued improvement in the health, safety, and well-being of all groups, including mothers (high risk obese women) and their children throughout the county. The county’s infant mortality rate for the three years 2017-2019 was 5.6/1,000 live births. Its Black infant mortality rate (8.8) was eight times higher than the rate noted for its white non-Hispanic infants (0.0, or 18 deaths). Blacks contributed 71% of the infant deaths. Further, state data continues to show disparities in IMR for Black women (8.9), which is 3.4 times the rate reported for their white counterparts (2.6). (NJ State Health Assessment Data or NJSHAD, 2019). Of interest is the fact that NCHC’s Healthy Start (HS) served 1,364 Black pregnant women and their families in the 2020-2021 grant period; nearly half obese. A total of 157 babies were born. Only nine infants were low birth weight, and there were no infant deaths. New Jersey is the 4th wealthiest state in the nation (worldpopulationreview.com, 2021). Yet Essex County, it second most populous county, ranks 19th in median household income among the state’s 21 counties. Some attributable factors to the county’s low economic ranking include the fact that four of its most populous communities, namely Newark, East Orange, Irvington, and Orange have large minority groups, and are plagued by social ills such as poverty, low literacy rate, and several well-known environmental factors with implicatio
ns for poor health outcomes. There is a preponderance of Medicaid-insured in these communities, including Newark (33.4%), the county seat (U.S. Census, 2015-2019); the site of three NCHC’s clinics. Medicaid-insured at NCHC in 2021 was 53%; another 24% were uninsured. The county also houses the state’s largest uninsured (11.6%), and Medicaid-insured (20%). State data show 7.9% and 17% for uninsured and Medicaid-insured, respectively (US Census, 2019; Medicaid in NJ, 2019). The county’s urban areas also report a disproportionate share of high school dropouts, students who are not entering college by October after they graduate from high school (49%), and low four-year college graduation rate; one in four graduates within six years (Wall, 2018). The 2018-19 graduation rate for Essex County College in Newark is 16% (only 2% completed their program within normal time), 24% for New Jersey Institute of Technology (NJIT) in Newark, and 33% for Rutgers University-Newark (Collegefactual.com, 2021). NCHC is aware that Black maternal and child outcomes and health disparities are shaped by what experts have deemed “broader interpersonal, institutional, community and policy factors such as institutional racism, providers’ cultural competence, access to quality health care, neighborhood quality, and economic and housing policy” (Alia, et al., 2010; Reno, et al., 2018). Therefore, to address the racial disparity in birth outcomes, NCHC is focused on implementing programs that will address Social Determinants of Health’s (SDOH) Domain 2 (i.e., Education Access and Quality), and Domain 3 (i.e., Health Care Access and Quality) which are proven to impact high infant mortality rates among Black women and their children. Education helps to build behaviors and habits that have a positive impact on health, while access to quality care helps address structural, policy and systems issues that reduce risk of both maternal and infant deaths.