Disparity In Health

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Assessment
Undoubtedly, the causality of infant mortality disparity seen among African American soon-to-be mothers is a major public health concern. It may not be one that can simply be measured by disparities in adulthood but shaped across an individual’s lifetime and potentially across generations as Freire (2000) eluded to in Pedagogy of the oppressed. In Orange County, FL whether the concerns streamed from Oppression or Residential Segregation or other additional factors, focusing on Communities and increasing collective efficacy mechanisms are vital and will be assessed.
People & Place
The Orange County, FL has a population just over 1.2 million people, where approximately 64% of the population is White, 20% Black and just over 16% of the population living below the poverty line (United States Census Bureau, 2010). The overall infant mortality rate is 7.5, exceeding the rate of the US (6.7) and Florida (6.1) (Florida Charts, 2014). The health disparity between African-Americans (13.5) and Whites (5.6), in the county is not only higher, but actually widens in comparison to the Florida rate (10.6 Blacks, 4.6 Whites,) (Florida Charts, 2014). In personal communication with D. Weister at the Health Department on October 28th, 2014 8 zip codes: 32805, 32808, 32809, 32811, 32818, 32819, 32835, 32839, with the highest rates and greatest need as the targeted areas for initiatives to reduce the aforementioned disparity were highlighted. Using census data, 5 of the zip codes are majority African American, and 6 have a greater percentage of the population living below the poverty line (US Census Bureau, 2010). The Pine Hills community in zip code 32808 has the highest rate in the county at over 14. A predominantly African American Community (68%), with 25% of the population living below the poverty line and 12% with a college degree (US Census Bureau, 2010). The community is often referred to as “Crime Hills” (although substantial efforts have been made, and there has been a reduction in crime rates), and as researchers eluded to, where you live can be a product of your health outcome. Policies Florida Legislature signed the Healthy Start System into Law on June 4,1991, creating the most comprehensive maternal and infant health initiative in the US which was implemented the following year (Florida Department of Health, n.d). The goal is “to reduce infant mortality, reduce the number of low birth weight babies, and improve health and developmental outcomes” (Florida Department of Health, n.d). Components of the program include: universal screening, continuum of care coordination – which included education (nutrition, pre-natal, child birth, parenting, etc), counseling, outreach, and community coalitions (Florida Department of Health, n.d). Orange County, abides by the Florida Statutes set forth on Maternal and Infant health to reduce the disparity in minority health by the Florida Legislature (2014): Identify factors in the health and social services systems contributing to higher mortality rates among African-American infants. It is also the intent of the Legislature that the initiative produces recommendations on how to address the factors identified by the reviews as contributing to these higher infant mortality rates. The black infant health practice initiative shall be administered through a collaboration among the department, federal and state healthy start coalitions, and public universities or colleges having expertise in public health. A local community shall develop an interdisciplinary team to serve as part of a statewide practice collaborative. Both perinatal periods of risk and fetal infant mortality reviews may be used (ch. 383.2162 para 1). Additionally, the chapter requires education for families and birth center workers. Birth center workers
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Lu et al., (2010) asserts “Elimination of racial disparities in birth outcomes is attainable if we look at the life course, and make intergenerational and social investments in communities.” In devoting time and resources to improving this disparity, education is the critical factor in mitigating this. In the article, A Quiet Crisis, Dr. Yvonne Maddox stresses the importance of understanding cultural competency in delivering the message (as cited in Tomer, n.d). Dr. Maddox further states, the assumption is often made that “at-risk-groups just do not get it,” but there are other factors, including lack of trust, not knowing that resources are available, or even knowing that a problem exists (as cited in Tomer, n.d). Subsequently the following questions were considered in conducting the

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