Strong Beginnings is expanding throughout the county

October 2, 2011
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Strong Beginnings, which has helped to greatly reduce infant mortality and low birth-weight deliveries in the local African-American population, is being expanded this year.

Since the program’s inception in 2004, Strong Beginnings has offered its many services to pregnant African-American women living in Grand Rapids. But this year, those services are being extended to other Kent County cities. On top of that, the program is unveiling a new service this year aimed at the fathers of the expected children.

The program’s expansion was made possible when Spectrum Health secured a $204,000 grant for the current fiscal year from the W.K. Kellogg Foundation. The funding will be used to add three outreach workers, maintain some current staffers and pay for needed supplies.

Strong Beginnings Program Director Peggy VanderMeulen said the funding is part of a five-year, $4.5 million grant Kellogg awarded the program. The Kent County Health Department will hire the three new workers; the agency is one of about 20 partners in the program.

“(The new hires) will work throughout all of Kent County in this expansion,” said VanderMeulen, who is employed by Spectrum Health but has her office in the African-American Health Institute.

Besides making an expansion of the program possible, the Kellogg Foundation grant is also allowing Strong Beginnings to hire an employee to work with expectant fathers. “We’ve long known of the importance of engaging fathers, addressing their needs, promoting responsible fatherhood, and helping them be better fathers by engaging them in the lives of their children. So we will soon have a full-time fatherhood coordinator, and we’ll also have a project coordinator that will allow us to expand our systems-level work throughout the community, particularly around the issue of racism,” she added.

Although Strong Beginnings began seven years ago, the concept was born in 2001 when 15 service agencies informally came together to discuss a growing concern: a startling disparity of positive outcomes among the birth of black babies and their white counterparts. The infant mortality rate then was three to four times higher for black births, and many more black newborns had lower birth weights than white babies, with some only weighing in the neighborhood of three pounds.

“We did community conversations. We looked at the national literature. We did our research, looked at local data, and we identified three key areas that would need to be addressed to help improve birth outcomes,” said VanderMeulen, who took part in those initial discussions.

The three areas were: preventing unplanned pregnancies; improving access to quality pre-natal and after-birth care that includes such social issues as domestic violence, a lack of food and transportation, substance abuse, and depression; and dismantling racism.

Quite a few action plans and activities came from those early meetings, and the group, known as the Infant Health Team, parked all of those under a new effort called Strong Beginnings.

“So we went around and did what we could. We carried out some activities in those areas and started to raise awareness about the issues and brought more people to the table,” said VanderMeulen. “Then in 2003, when Grand Rapids had the highest black infant mortality of any city in Michigan, we decided we really needed to put some serious money behind this because it’s a big issue.”

The Infant Health Team, which operated then under the Healthy Kent 2010 umbrella, brought the hospitals and other players such as Cherry Street Health Services and the African-American Health Institute together to apply for federal funding from the Healthy Start program operated by the Department of Health and Human Services. Healthy Start had been around for a couple of decades and was established to lower birth disparities between races, so that program became a natural revenue source for the new local enterprise.

In addition to reducing infant-mortality rates and the number of low-weight births, the program also strives to cut the number of unplanned pregnancies, lengthen the spacing between births to a minimum of 18 months, raise the access to medical homes, lower stress and depression among mothers, and improve the overall system of care.

Like all the 100 Healthy Start projects nationwide, Strong Beginnings works at two levels. One provides direct services to needy mothers-to-be and moms of children up to 2 years of age, and that’s done through home visits, education, mental health services, case management and other activities. The program also works at the system level, both in the community and with the state, to provide overall care to mothers and to their newborns.

But the Healthy Start initiative, which funds Strong Beginnings at $750,000 annually, initially limited the local program to only serving black women who lived in Grand Rapids. But because of the Kellogg grant, women in Kentwood, Wyoming and other locales can now take part in the program.

“At times last year, we had a waiting list for our program. We were just beyond capacity,” said VanderMeulen, who was with Cherry Street Health Services when she took part in the initial discussions a decade ago.

Today, Strong Beginnings has racked up quite a bit of success despite 80 percent of its clients being 100 percent below the poverty level, with almost all below 185 percent of that same income level. Forty percent suffer from moderate to severe depression, 20 percent are in abusive relationships, 20 percent admit to being substance abusers, and about 30 percent are homeless during some of their time in the program. By homeless, VanderMeulen explained they may not be living in their car or on the streets, but are often on the move, shuffling from one friend or relative to another. “We really do work with some of the highest-risk women in our community,” she said.

With that said, Strong Beginnings has reduced the rate among its clients for low-weight births to 5.8 percent from the 17 percent the program started with in 2004. For all African-American births in Grand Rapids, the low-birth weight figure is 14 percent. The infant mortality rate for the program’s clientele is 8.1 for every 1,000 births, while it’s 17.3 per 1,000 births for all black pregnancies in Grand Rapids.

“I am so happy with the outcomes we’ve had so far,” said VanderMeulen. “We’ve also seen increases in breast-feeding rates among our participants and significant decreases in stress and depression scores. So I think we are having a positive effect.”

VanderMeulen made it clear to the Business Journal that Strong Beginnings can’t and won’t accept all the accolades for dramatically improving the status of births and the rearing of young children among African-American women, as other worthwhile programs also have played important roles.

“It’s really hard to pinpoint what exactly leads to increases or decreases in infant mortality from year-to-year. We do think we are having an effect — again, because our participants have such low infant-mortality rates, so I’m sure that’s helping to bring down the overall Grand Rapids rate,” she said.

“But there are other programs in the community as well that are doing some good work, like the MOMs program, and the overall work being done by Healthy Kent 2020 and some of those other community agencies. So I suspect that it’s kind of a combined effort by all those efforts put together.”

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