TAKING THE LEAD: Thaysha Mejina, center, speaks with Jennifer Rossi, left, program coordinator for the Environmental Justice League of Rhode Island, and Judith Russell, right, nurse at Nowell Leadership Academy, where Thaysha is a student.
Rhode Island is paying more attention to the urban mother-child relationship and its effect on children's health and development from cradle to workforce through newly established "health equity zones."
Established this past spring, two of the 11 HEZ projects federally funded with $2.7 million from the U.S. Department of Health will focus on maternal and child health outcomes.
The geographically defined zones were created to support improved birth outcomes, better social and environmental conditions in neighborhoods and prevention of chronic disease. Each zone numbers at least 5,000 residents in areas that include Providence, Woonsocket, West Warwick and Bristol.
"It is our expectation these geographic areas we're investing in, where these people are working and going to school, are going to be improved in three years," said Ana Novais, executive director of the R.I. Department of Health and Title V Maternal and Child Health director. "They'll feel more ownership in their own health individually and in improving and maintaining the conditions of the place where they live."
Not only are those overall improvements in health expected in the short term, especially for infants, but also in the long term, in school and workforce readiness, said Rebecca Boxx, director of the Providence Children and Youth Cabinet, one of the two lead agencies heading up an urban health zone in Providence focused on the parent-child connection.
"Most of the focus is on actual outcomes for the children, but understanding the mom's and parents' roles [are] important, too," said Boxx.
"We work under the ideal of a cradle to career approach. If we want a healthy, vibrant workforce we need a successful, young workforce and that starts at birth. Our whole intent is to get the community working to support students and families along that trajectory," she said.
The improvements the youth cabinet and the Environmental Justice League of Rhode Island are aiming for are evidence-based, and include such things as fewer emergency-room visits for unintentional child injuries or abuse, as well as more bonding, breastfeeding, greater school readiness and economic self-sufficiency, said Novais and Kristine Campagna, home-visiting program manager for DOH.
Home visits are part of the programming built into the HEZ maternal and child health outcomes, which began in April with programming led by the Providence-based Environmental Justice League of Rhode Island. Programming through the Providence Children and Youth Cabinet begins in the fall.
Of the $2.7 million total, the league is receiving $151,000 for the first year to cover a mix of objectives, with $40,000 of that dedicated to maternal and child health outcomes, said league project coordinator Jennifer Rossi, who is also project coordinator for and a co-founder of the Rhode Island Doula Collective of Providence.
The youth cabinet is receiving $275,247 in its first year, Novais said. Funding for each of the health-equity zones would be renewed annually for up to three years based on results, she added.
Elizabeth Burke Bryant, executive director of Rhode Island Kids Count, a project of the Annie E. Casey Foundation, said making sure pregnant women have access to prenatal, birth and post-partum health care has been a focus of Rhode Island policymakers for more than two decades.
Home visits are integrated into the care that the youth cabinet and league will be providing, said Campagna and Bryant. The federally funded Rhode Island Family Home Visiting System enrolls about 800 families, combined, in three programs, they said: nurse family partnerships, healthy families and parents as teachers.
"Each program is focused on making it more likely pregnant women enrolled in the program will have a healthy pregnancy," Bryant said. "And when their baby is born, they will receive the information they need to be able to ensure the healthy development of their babies."
In Providence, the league will serve 10 teenage mothers and families over the course of the year with prenatal, delivery and post-partum care, working with partners like the Nowell Leadership Academy, said Rossi. The program has already helped one mother.
Rossi, who had helped Tahisha Mejia, 18, of Providence, through the birthing process of her son, Elian Manuel Mejia, in March, has since provided help for Meija's post-partum care by informing her about breastfeeding. Mejia has consulted with Rossi about finishing high school at Nowell Academy and Mejia's mom is babysitting, they said.
Boxx said her organization may partner with Incredible Years, a 14-week, evidence-based program designed to guide parents, teachers and children in promoting the emotional and social well-being of children.
Incredible Years is a national program offered in Providence by the Providence Center, a nonprofit focused on behavioral health assistance and an affiliate of the Care New England health system.
"We think Incredible Years could be a powerful part of a health-equity zone investment," said Garry Bliss, the Providence Center's director of government and external relations.
Bryant noted that Rhode Island is leading the nation in children's health insurance coverage, and 12th in the country for state's with fewer preterm births and low birthrate babies, but 31st for infant mortality.
"We've got to keep the momentum going [for improved outcomes]," she said. •