Here’s The Plan To Fix New Jersey’s 'Racist' Infant Mortality Gap

NEW JERSEY — The numbers speak for themselves, New Jersey advocates say: Black babies born in the state are three times more likely to die before their first birthdays than white infants.

It’s not just babies who face a startling mortality gap in the Garden State, either. Black mothers are seven times more likely than white mothers to die from pregnancy-related complications. And something needs to be done immediately, a rising chorus of Garden State mothers and state officials insist.

On Monday, New Jersey first lady Tammy Murphy and national public health expert Vijaya Hogan unveiled the Nurture NJ Maternal and Infant Health Plan, a strategy to reduce the state’s mortality gap by 50 percent over five years.

It’s the latest element of Murphy’s Nurture NJ initiative, which aims to make New Jersey “the safest and most equitable place in the nation to deliver and raise a baby.”

There are three parts to the plan:

• Ensure all women are healthy and have access to care before pregnancy
• Build a safe, high quality equitable system of care for all women prenatally through postpartum care
• Ensure supportive community environments during every other part of a woman’s life so that the conditions and opportunities for health are always available

Black mothers aren’t the only ones who face odds they shouldn’t. Hispanic women in New Jersey experience twice the rate of infant mortality compared to white women, researchers pointed out.

Ironically, New Jersey is doing very well when it comes to its overall infant mortality rate, which is the fifth-lowest in the nation. But this seemingly low rate can be misleading if not probed further, officials said.

“Currently, New Jersey is ranked 47th in the nation for maternal deaths and has one of the widest racial disparities for both maternal and infant mortality,” Murphy stated in her executive summary.

“This disturbing reality is a result of nothing other than institutional racism,” Murphy added.

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HERE’S THE PLAN

It took a year of meetings with more than 100 health experts, community groups and Garden State families before the Nurture NJ Maternal and Infant Health Plan was finalized, officials said.

Some recommendations from the plan include:

• Declare racism a “public health crisis”
• Develop public-private partnerships to implement place-based, community partnered change models in areas with the highest Black maternal and infant morbidity and mortality and then expand to every community across New Jersey
• New Jersey should affirmatively provide for comprehensive family planning services and reproductive autonomy through policy and in funding
• Develop a communications plan to promote benefits of midwifery and community doula models of care
• The state should continue to invest in opportunities for safe, decent, toxin-free affordable housing
• The Department of Human Services should strengthen efforts to make the health system accountable to women of color through reliable coverage and evidence-based care
• The Secretary of Higher Education should expand successful programs that improve access to high quality education
• The Department of Treasury should increase uptake of the Earned Income Tax Credit
• The Department of Labor should continue their efforts with employees and employers to expand utilization of the paid family leave benefits
• Increased utilization and expansion of the Women, Infants and Children (WIC) Program and Supplemental Nutrition Assistance Program (SNAP)
• The Department of Health should work with state leaders to provide breastfeeding support in communities for both mothers, fathers and other partners

The road to recovery isn’t going to be easy, however. According to state officials:

• In 2017, the Black infant mortality rate (9.4/1,000 live births) was over three times that of the white infant mortality rate (2.7/1,000 live births). Although Black infants make up 13.4 percent of all births, they account for 28 percent of all deaths.
• Medicaid serves as a significant insurer of pregnancy and birth care for women. Over the period 2013-2018, half of all births to Black women were insured by Medicaid, as were 45 percent of Hispanic births and 17 percent of white births.
• According to internal analysis of New Jersey Perinatal Period of Risk data, the leading causes of infant death are prematurity and other perinatal conditions. Twenty percent of Black infant deaths and 29 percent of Hispanic infant deaths fall into this category while only 6 percent of white deaths are attributed to this cause.

BATTLING THE GAP IN NJ

There has been a rising effort to fight New Jersey’s infant mortality gap in recent years.

In the fall of 1996, a blue ribbon panel on Black Infant Mortality was convened to formally study the problem of infant mortality in New Jersey. The panel developed a series of recommendations to address the high rates of Black infant mortality.

Meanwhile, a statewide campaign dubbed Healthy New Jersey 2000 set a goal to decrease Black infant mortality from the 1996 rate of 16.3 per 1,000 live births to 11 deaths per 1,000 live births by 2000. However, that goal wasn’t reached until 2011, about 11 years after the target date.

In March 2020, federal officials announced that the U.S. Department of Health and Human Services announced an award of $1,122,899 for a federally qualified health center in Newark to help lower the local infant mortality rate. The center also has satellite locations in East Orange, Irvington and Orange.

• See related article: $1M Boost Will Fight Infant Mortality Gap In Essex County

In October 2019, a coalition of Garden State residents calling themselves the New Jersey Birth Justice Collective took to the streets of Newark in an attempt to raise awareness and funds to support black infant and maternal health.

Advocates from Atlantic City, Camden and Trenton – including representatives from the New Jersey Department of Health (NJDOH) – participated in a “Walk for Black Babies,” marching to the steps of Newark City Hall and talking with local community members along the way.

The event was organized in solidarity with Families for Equity, Baby Please Birth Services, Sister to Sister Community Doula Program, Uzazi Village, NJ Breastfeeding Coalition, Ahava, Community Doulas of South Jersey, Perinatal Health Equity Foundation, Chocolate Milk Café/NY/NJ Chapter and Majuta Wellness and the New Jersey Department of Health.

• See related article: March In Newark Raises Awareness About Black Infant Deaths

In March 2019, the NJDOH announced that it would be providing funding to hire 77 outreach workers — 40 doulas, eight "community health workers" and 29 community health worker supervisors — in an effort to boost the well-being of mothers-to-be in the Garden State.

The round of funding was part of the department's $4.7 million investment in the "Healthy Women, Healthy Families program," launched in response to the state’s alarming disparity in black and white infant deaths.

• See related article: Doulas Hired In New Jersey To Fight Baby Mortality Gap

‘NOT JUST A QUICK FIX’

On Monday, a chorus of health experts and elected officials offered support for the Nurture NJ Maternal and Infant Health Plan.

They included:

Lt. Gov. Sheila Oliver – “This plan is not just a ‘quick fix’ — it’s a long-term strategy that will result in the systemic change needed to reach our goal of making New Jersey the safest and most equitable place in the nation to give birth and raise a baby. By focusing on equity, we can more effectively transform a system that has been failing New Jersey’s women of color for too long.”

U.S. Rep. Bonnie Watson Coleman – “Nationally and in New Jersey, maternal and infant mortality are among the worst disparities that Black women experience. We are bombarded by stories that prove this issue crosses socioeconomic boundaries, and despite decades of awareness, we’ve struggled to move the needle. It will take coordinated effort at every level to change these statistics, and I am grateful that the First Lady continues to use her platform and her power to be part of those efforts. This is another tremendous opportunity for our state to set the example for others to follow, and I will continue to ensure the federal government does its part to give every mother and infant a safe and healthy start.”

U.S. Rep. Frank Pallone – “I applaud the First Lady’s Nurture NJ Strategic Plan and am grateful for her leadership on this important issue. We must work together to improve the health outcomes for new and expecting mothers and their children. As Chairman of the Energy and Commerce Committee, I’ve worked to pass legislation out of my Committee to address maternal mortality and morbidity and to reduce health care disparities. I look forward to continuing to work in Congress and with First Lady Murphy to improve health outcomes and ensure that new mothers and their children have access to the care they need.”

New Jersey Assembly members Shavonda Sumter, Verlina Reynolds-Jackson, and Herb Conaway – “The plan introduced today is a major step forward in our state’s ongoing efforts to improve the maternal health outcomes of New Jersey mothers. With input from experts, advocates and the very families directly affected by this issue, the Nurture NJ Maternal and Infant Health Strategic Plan will undoubtedly lead to significantly positive change on behalf of the mothers and newborns in our state. While our work is far from over, we are proud to support a plan that will help get us closer to our goal of making New Jersey a safe, reliable place to start and grow a family.”

New Jersey Senator Nellie Pou – “It is clear that maternal health care needs to be improved, especially for women and families who don’t have equal access to medical services. We need a game plan that strives to make New Jersey a model for maternal care that is safe and available. This can make a real difference in the good health of infants, their mothers and the families for their entire lives. I applaud the work of everyone who played an active role in putting this plan together.”

Dr. Kimberly Boller, chief strategy and evaluation officer at The Nicholson Foundation – “All of us have a role to play in addressing inequities in maternal and infant mortality in New Jersey, and the development of the Nurture NJ strategic plan is a great example of the private and public sectors coming together to make a positive difference. We look forward to continuing this multi-sector collaboration to ensure the implementation of these recommendations, guided by science and the experience of mothers and their communities.”

Wendy McWeeny, director of U.S. initiatives at Community Health Acceleration Partnership – “The Community Health Acceleration Partnership is honored to be a part of the First Lady’s collaborative approach to addressing health injustice and improving outcomes for all birthing people in the state. The Nurture NJ strategic plan will ensure a coordinated response, centered in communities that can serve as a model for all states.”

Vivian M. J. Darkes, NAACP NJ state secretary and health chair – “The NAACP NJ State Conference applauds and stands with First Lady, Tammy Murphy, and the Nurture NJ Collaborative as it addresses this Black Maternal and Infant Crisis that affects many regardless to access or money. It is time that we acknowledge this issue and declare racism the social emergency that it is. We must join this collaborative in its quest to build racial equity infrastructure and capacity while engaging trusted voices within the communities, including people of color in the overall structure from the top to the bottom.”

Dr. Rahul Gupta, chief medical officer and senior vice president at March of Dimes – “Women of color experience some of the highest rates of health inequalities due to societal, economic and environmental factors that impact their health. The Nurture NJ Strategic Plan will go a long way in tackling these social determinants of health, as well as the structural and systemic inequities that we see in our health care system. We’re honored to support this transformative and innovative approach to improving maternal health outcomes which has the potential to serve as a national model.”

Mary-Ann Etiebet, executive director of Merck for Mothers – “Initiatives like Nurture NJ provide a roadmap that keeps women at the center of solutions. By expanding how quality care can be provided and integrating evidence-based strategies to reach everyone, we can make our maternal health systems more resilient, now and in the future.”

Dr. Nastassia Davis, founder/executive director at Perinatal Health Equity Foundation – ““The maternal death rate for Black women in NJ is seven times that of white women. Black women in New Jersey are in a state of crisis. Just this December we lost a Black mother named Jenayha Nulums to a post birth hemorrhage which was likely preventable. The Nurture NJ plan will complement the Black Mamas Matter Alliance’s plan as they both provide solid framework of the necessary steps to move the needle forward. We have talked about these statistics long enough, it is time to put our words into actions.”

• See related article: NJ's Black-White Infant Mortality Gap Is 'Shameful': Tammy Murphy
• See related article: New Jersey's Black Infants, Moms Face Mortality Gap, Lawmakers Say

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