Sacramento County, California’s Twenty-Year Child Death Review Team Report 1991-2009 found that African American children were dying at more than twice the rate of any other ethnicity and that disparity had existed for more than 20 years. African American children comprised 12% of the county child population and 22% of all child deaths, including 32% of all infant sleep-related deaths. After this startling statistic was reported by the Child Death Review Team, the Sacramento County Board of Supervisors created a Blue Ribbon Commission to study the disparity, and in 2013 adopted their recommendations that included the creation of the Black Child Legacy Campaign which is working to reduce deaths of African American children in Sacramento County.
In 2014, the Child Abuse Prevention Council of Sacramento was funded to address the disproportionate number and rate of African American sleep-related deaths. Child Abuse Prevention Council of Sacramento reviewed Child Death Review Team data, performed extensive outreach to the African American community, gathered qualitative data and input, and engaged African American expectant/new parents and their parents to create a culturally responsive education campaign that promotes the American Academy of Pediatrics recommendations. Safe Sleep Baby is an education campaign created by parents for parents with messages delivered by Sacramento County parents who lost their baby to a Sudden Unexpected Infant Death (SUID). A February 6, 2023, evaluation titled First 5 Sacramento Reduction of African American Child Deaths FY 2021-2022 found that between 2012-2014 and 2018-2020, African American infant sleep-related deaths decreased 54%, exceeding the targeted reduction of 33% by 2020. Additionally, the disparity gap between African American SUID and all other ethnic groups also decreased 60% since 2012-2014.
Despite these positive outcomes, a closer look at the data reveals that:
• Every other week in Sacramento County, a baby dies while sleeping without SUID prevention.
• Infants referred to child welfare are nearly four times as likely to die of a SUID.
• African American infants are more likely to die.
• 70% of SUID occur in seven Sacramento County neighborhoods.
• Sacramento County’s SUID rate is twice that of the state.
The Child Abuse Prevention Council of Sacramento and the Sacramento County Child Death Review Team, in collaboration with Child Safety Forward Sacramento Prevention Cabinet and 23 public agencies, community-based organizations, and community representatives seek to implement Safe Sleep Baby Safer ABCs for Everyone. A collaborative partnership will be leveraged to improve our infant safe sleep prevention work applying the The New Spectrum of Prevention public health framework for action at the individual, services, community, and policy level (Rattray, MPH MSW; Brunner, MD, PhD; Freestone, MS; 2002
The outcomes we propose to achieve are:
• Increase in high-quality, timely data for SUID, including information on disparities and Social Determinants of Health, for program improvement and public health purposes.
• Increased engagement opportunities for networking, cooperation, and data sharing with communities disproportionately impacted by sleep-related deaths.
• Increase in the number of implemented policies and practices to standardize and reduce inequity in investigation practices, including review of medical records, scene investigation and autopsies.
• Increase in implementation of community participatory, data driven prevention strategies for disproportionately impacted communities.
At the end of the five-year grant period, we expect that increased SUID data will inform the development and implementation of improved community driven SUID prevention strategies to further decrease Sacramento County’s SUID rate and disparity.