Dr. Salihu leads state initiative to tackle black infant mortality

USF public health researcher Dr. Hamisu Salihu directs the Center for Research and Evaluation, Chiles Center for Healthy Mothers and Babies.

Black infants are more than twice as likely as white infants to die before their first birthday, and the racial disparity gap in infant mortality is widening.

This disproportionate burden is a major problem in Florida, where the death rates for black infants climbed between 2000 and 2004, defying an overall national decline. In some counties in Florida, including Hillsborough, the black infant mortality rate is more than four times the white infant mortality rate.

“We won’t solve this problem overnight,” said Hamisu Salihu, MD, PhD, associate professor of epidemiology at the University of South Florida College of Public Health. “But we have a growing understanding of some of the major medical and social factors causing these high infant mortality rates, including prematurity and very low birth weights. Now, we have to transform the research findings into effective, innovative strategies to identify women at high risk for poor birth outcomes and intervene early to reduce the horrible impact of infant mortality among blacks.”

A leading researcher in the field of infant mortality, Dr. Salihu is a key player in the Black Infant Health Practice Initiative, which was approved last year by the Florida Legislature.

The legislation established a statewide collaborative — the Black Infant Health Practice Collaborative (the Collaborative) — to address the racial gap in infant deaths in Florida and to recommend policy changes at the local and state levels.

The black-white disparity in infant mortality rates rose from 1.9 in 1970 to 2.3 in 2006, according to the Florida Department of Health. Researchers have consistently shown that higher rates of premature births among black women, regardless of their class or income, help drive this persistent gap.

Recent studies by Dr. Salihu have also shed new light on the role of maternal obesity in the black-white gap in infant mortality. Those studies showed that infants of obese black mothers not only had a higher risk of stillbirth than infants born to white women, but also were more likely to die within the first 27 days after birth.

To continue the work of the Collaborative, Dr. Salihu was recently awarded a one-year, $254,000 W.K Kellogg Foundation grant to help community coalitions develop evidence-based action plans to reduce high black infant mortality rates in eight Florida counties — Broward, Dade, Duval, Gadsden, Hillsborough, Orange, Palm Beach and Putnam. He is working with a team of diverse multidisciplinary faculty and staff at the USF College of Public Health, the Lawton and Rhea Chiles Center for Healthy Mothers and Babies, Florida A&M University, and Florida Healthy Start. The Kellogg project is training community coalitions how to effectively collect, analyze and interpret data so that it can be most effectively used in shaping culturally-relevant strategies for reducing black infant mortality.

The goal is to arm communities with the tools needed to prevent and combat diabetes, hypertension, obesity, stress or other factors that may increase the risk of low birth weight or premature births.

The Collaborative, supported by the Kellogg grant, gathered at the statewide Minority Health Disparities Summit in Tampa Aug. 12 and 13 to discuss research findings and each team’s plan to impact infant mortality in their communities. The Collaborative also met with 30 black community leaders who will take an active role in championing ways to improve birth outcomes among women who are pregnant and help serve as advocates for needed policy changes. In addition, members shared integrated strategies to improve maternal health before conception, which was identified as the single most important factor compromising fetal-infant health.

“Three maternal health factors were repeatedly mentioned as being critical — single motherhood and lack of the father’s involvement, maternal obesity, and absent or poor breastfeeding practices,” Dr. Salihu said.

High infant death rates are not just a threat to the black community, but to society as a whole, Dr. Salihu emphasized. “Poor infant health impacts the overall societal goal of achieving quality health – an ingredient that is capital for the social, political and economic development of our nation.”

Dr. Salihu is the principal investigator for the Kellogg grant. Other team members include Dr. Charles Mahan, Dr. Deanna Wathington, Dr. Amina Alio, Dee Jeffers, Estrellita Berry, Dr. Deborah Austin, Dr. Alfred Mbah, Dr. Lakshminarayan Rajaram, Christina Bernadotte and Alice Richman.

- Story by Anne DeLotto Baier, USF Health Communications
– Photos by Eric Younghans, USF Health Media Center