Success Story: New Jersey

At a glance

State officials in New Jersey used Pregnancy Risk Assessment Monitoring System (PRAMS) data to explore factors associated with infant mortality and provide information to support community-based approaches to reduce mortality among Black infants.

woman holding infant

Reducing infant mortality in Black communities

Problem

  • In 2017, the mortality rate among Black infants in New Jersey was more than 3 times that of White infants, a disparity that had remained constant for at least 10 years.
  • Improving maternal and infant health and reducing mortality among Black infants was a top priority of the New Jersey Department of Health (NJDOH).

PRAMS data to action

  • In 2018, the New Jersey (NJ) PRAMS team analyzed PRAMS data for timing of prenatal care, barriers to receiving prenatal care, experiencing stressful life events, attending postpartum visits, experiencing postpartum depression, breastfeeding, and bed sharing practices.
  • These data highlighted opportunities for improvement. For example, Black mothers had the lowest rates of postpartum checkups (82%) and breastfeeding initiation (81%). They also had the second highest rates of postpartum depression symptoms (14%) and reported "often or always" bed sharing (32%).

Results

  • In 2018, staff from NJDOH Reproductive and Perinatal Health Services and the NJ PRAMS Team used results from a root cause analysis and focus groups to develop a new Healthy Women, Healthy Families (HWHF) Initiative. The goal of this 5-year initiative (2018–2023) was to improve maternal and infant health outcomes while reducing racial, ethnic, and economic disparities through a coordinated community-driven approach.
  • The NJDOH commissioner appropriated $4.7 million per year in grant funding to community-based organizations for the first 2 years of the HWHF Initiative.
  • The HWHF Initiative used this funding to award grants to eight community-based organizations to carry out case management services using community health workers (CHWs), develop diverse community partnerships, and convene a diverse community advisory board.
  • Case management programs to reduce infant mortality through this initiative can include group prenatal care, community doulas, and programs such as breastfeeding and fatherhood support groups.
  • By the end of year 2, NJDOH trained 79 doulas and hired 30 CHWs and 13 CHW supervisors.
  • As of June 2020, almost 49,000 women had received case management services, and over 25,000 women had been referred to programs such as home visiting and Healthy Start.