In 2006, Gov. Phil Bredesen joined Shelby County Mayor A C Wharton and more than 200 stakeholders from state and county government, and legislative, not-for profit, education, faith-based and health care communities to develop and outline a strategy to address infant mortality in Tennessee. Since the strategy’s implementation, more than $17 million has been invested statewide on work that spans programs in health and training education, home visiting, and clinical care for mothers and babies in local communities like Memphis, Chattanooga and Nashville, officials said.

“The Office of Children’s Care Coordination along with local officials and partnering organizations are putting in place the best and most successful programs from across the country to give babies the very best chance at being born healthy,” said Bredesen. “At the core of our progress are the enthusiasm, dedication and hard work of local community leaders and health professionals who are providing services and utilizing practices that have been successful to improve the health outcomes for this vulnerable population.”

The ABC news program, “20/20” is airing a story on Friday about the impact and emotional toll of infant mortality in Memphis. In the state’s largest metropolitan city, the infant mortality rate was 16.1 in 2006, the most recent year for which data are available. This is nearly two times greater than Tennessee’s rate of 8.7. Overall, Tennessee’s infant mortality rate is ranked 45th compared to other states. The infant mortality rate for Tennessee’s African-American babies is more than twice the rate for white babies.

“The state is moving in the right direction by engaging local community leaders and partners, providing cutting-edge care, and implementing evidence-based practices,” said Bob Duncan, director of the Governor’s Office of Children’s Care Coordination. “This multipronged approach is allowing us to sow seeds that when sufficiently nurtured will change the infrastructure, allowing us to reap rewards for decades to come.”

The Office of Children’s Care Coordination provides funding and works with local communities to help determine the solutions best suited to address the issues unique to individual communities.

Examples include:

· Centering Pregnancy is an evidence-based approach to group prenatal care that provides clinical care, in addition to creating a supportive community of women to go through pregnancy together. It has been shown in clinical trials to reduce prematurity and low birthweight. Nine sites across the state are being funded to provide this care. So far, the Memphis program has provided care for 90 women. Once full capacity is reached, each site is anticipated to serve 200 to 500 women per year.
· The Community Voice program teaches volunteers in at-risk communities to be leaders in spreading good health information. Armed with knowledge and methods for spreading it, they support their friends and neighbors in making healthy choices such as not smoking in pregnancy, seeking care early and ensuring that babies are put to sleep in the safest position, on their backs.
· In 10 counties in East Tennessee, medical professionals who see pregnant women are being given the training and support to help their patients stop smoking, which is known to improve birth outcomes.
· Tennessee is one of a few states nationally to engage in a unified and concerted effort to implement quality improvement approaches in neonatal intensive care units across the state.
· Home visiting programs give women the support they need to take care of themselves and their babies. Home visits help women make choices about their behavior and how they care for their babies in their homes, but also facilitate access to medical care when it is needed. Home visiting programs are being funded in Shelby and Hamilton Counties.

Factors that can increase the risk of infant mortality include low birthweight (babies weighing less than five pounds, eight ounces); a mother’s lack of high school diploma or equivalent; a mother’s lack of prenatal care and/or use of alcohol, tobacco and other drugs; and improperly placing babies on their stomachs to sleep. However, planned and properly spaced pregnancies, early and regular prenatal care, breastfeeding, strong family support, regular exercise, avoidance of alcohol and drugs, women of child-bearing age knowing to take folic acid, and safe sleep practices are essential components in reducing infant mortality.

Also, racial disparities exist in infant mortality. African-American babies are more than twice as likely to die before their first birthday as white babies, and black mothers are also twice as likely to receive inadequate or no prenatal care as white mothers. Furthermore, black infants die twice as often as white infants from Sudden Infant Death Syndrome, which is associated with poor sleep practices for babies.

The Governor’s Office of Children’s Care Coordination, the Children’s Cabinet and the state Department of Health continue to explore and develop new partnerships and collaborations with other state governmental agencies; local, municipal and county governments; community-based organizations; and business and faith-based communities that share the vision of seeing more babies survive to their first birthdays.