Community Based Efforts to Address Infant Mortality and Disparities in Oklahoma.

IMPORTANCE: Oklahoma's infant mortality remains among the highest in the nation.1 Infant mortality rates are highest within the African American community.2 Physician and community partner efforts to decrease infant mortality are discussed to encourage more involvement in addressing infant mortality. The purpose of this article is to describe both provider and community-based efforts to combat infant mortality, particularly those focused on infant mortality disparities. OBSERVATIONS: The leading causes of infant deaths are prematurity, congenital malformations and/or chromosomal anomalies, and unclassified deaths such as Sudden Infant Death Syndrome or accidents. Prematurity accounts for the highest number of infant deaths. Efforts in Oklahoma focus on prematurity and SIDS prevention. Fetal Infant Mortality Review programs in Oklahoma and Tulsa Counties focus on local issues contributing to infant mortality and promote community engagement. In central Oklahoma, an Infant Mortality Alliance (IMA) was formed including over 180 stakeholders focusing on healthcare access, community and faith engagement, and health disparities. In the year following the IMA's initial work, the non-Hispanic African American infant mortality rate in Oklahoma County decreased by 18.8%.12. CONCLUSIONS AND RELEVANCE: Infant mortality is multifactorial and requires multiple strategies to combat. To address infant mortality and disparities, all aspects of the community must be involved. No individual alone can improve infant mortality. Physicians providing prenatal care make an impact by implementing recommended guidelines for progesterone therapy. Physicians seeing infants can encourage safe sleep practices among their families and local hospitals. While progress has been made addressing Oklahoma's infant mortality, much work remains.

Oklahoma's fetal and infant mortality review projects.

In Oklahoma, the infant mortality rate is higher than the national rate. Fetal Infant Mortality Review (FIMR) is an effective perinatal systems intervention. FIMR gathers information from medical, social, and community sources taking a comprehensive look at how well these systems are serving women and infants. It is important to understand that FIMR is a method to develop community-based plans to reduce fetal and infant mortality. It is not a quick-fix solution to a complex problem, a research study, an institutional review, or a system for assigning blame or responsibility for a death. FIMR has been instrumental in identifying what health care providers, community leaders, and citizens can do to improve the health and lives of babies in Oklahoma. Key steps include: (1.) Data abstraction (2.) A home interview (3.) A review of individual case summaries (4.) Development of community-based solutions and interventions designed to improve service systems and resources