Project Summary
In Columbus Ohio’s Linden neighborhood, a historically segregated and disinvested community that has been
devastated by decades of discriminatory race-based policies, infant mortality rates (IMR) are over 20 deaths per
1,000 live births (2%) with racial disparity ratios nearing three. Researchers have linked infant mortality and poor
birth outcomes to maternal education, maternal experiences of stress and discrimination, pove rty, lack of access
to healthy foods, lack of stable housing, and lack of access to prenatal/medical care. These risk factors are
concentrated in majority minority neighborhoodsdue to historical and contemporary policies and practices rooted
in structural racism (e.g., redlining, restrictive covenants, unfavorable zoning) that segregated both people and
resources within communities. Linden is apredominately Black (63%) neighborhood with apopulation of 180,000
residents, of which approximately 45% live below the federal poverty level. Building on Nationwide Children’s
Hospital’s (NCH) history of housing and community development through its Health Neighborhoods/Healthy
Families community partnership on the city’s south side, NCH targeted re-investments in Linden are intended to
improve housing quality and affordability, educational outcomes, access to healthcare, economic development,
and social connections of residents. Informed by Life Course Theory (LCT), the objective of this proposal is
to describe discriminatory policies influencing IMR and other maternal and child health experiences and
outcomes across generations of Black women and importantly, demonstrate how community re-investment can
be designed to target and rectify historic and contemporary structural racism and discrimination. Specifically,
we aim to: (1) examine the experiences of multiple generations of Black women on the intersection of structural
racism and reproductive health through the lens of historical and contemporary policies that effect
communities; (2) conduct real-time formative evaluation of a targeted community investment initiative explicitly
informed by the community’s history of structural racism; and (3) measure relative changes in short term infant
and maternal health disparities in the target community and a statistically matched comparison geography.
