The Crisis

A Community in Crisis

The Bad News

Kansas City is a large metropolitan area that encompasses two states (Missouri and Kansas) and seven counties.  The city of Kansas City is actually two cities: Kansas City, Kansas, and Kansas City, Missouri which sit side by side with the state line between them.  They are surrounded by suburbs on all sides which totals a population of 1,000,000 in the metropolitan area.  The larger city of Kansas City, Missouri makes up half that number.   Health conditions in the urban core for both cities have been impacted by state and county divisions that vary wildly between what services are available to whom depending on residency, urban sprawl, which leads to investment of surrounding suburban communities and neglect of the urban core, a lack of core services in the urban core, the ongoing economic downturn which has a disproportionate negative impact on already underserved communities, urban renewal plans that displace rather than renew, food and job scarcity, a public school system that is challenged, and changes in healthcare delivery that continue to disenfranchise those who most need to access care.  The problems are complex and compounded by long entrenched social barriers that keep the city divided along racial lines.

The Good News

Kansas City is a vibrant and caring community full of individuals, institutions and organizations that care about their city, their neighborhoods, and their people.  We can all work together to create solutions to the problems that plague the urban core. These issues are multi-faceted and some firmly entrenched.  Issues such as joblessness, gun violence, infrastructural neglect can’t be fixed overnight, and all have an impact on health and well being.  There are many good people already involved in good works, and there are healthcare agencies committed to serving in the urban core.  Uzazi Village will focus its programs, education and support on new mothers and babies getting off to a good start together, and will work with existing agencies to avoid duplication of services.

The focus of Uzazi Village programming, education and support is to decrease the incidence of prematurity through:

  • peer to peer education and support models
  • education that is population and culturally specific
  • promotion of innovative prenatal care models that attract rather than repel, and that build up rather than penalize
  • empower women to create and implement their own reproductive life plans

Facts

African-American babies are twice as likely to die than their white counterparts.

Kansas City, MO Health Department tracking infant mortality rates for the past 14 years.

Infant mortality rates for the black and white population in Kansas City over the past 14 years

Source

Dr. Jinwen Cai / Missouri Department Health and Senior Services and Kansas City Missouri Health Department

More Facts

These statistics were gathered from the Fetal Infant Mortality Review Board of Kansas City, MO.  The data was gathered from 10 zipcodes all located in the urban core: 64109, 64110, 64123, 64124, 64127, 64128, 64130, 64131, 64132, 64134.  These zipcodes were selected for data analysis because they had the highest infant death rates.

In this group of 103 infant deaths over a four year period (2004-2010)

  • 85.4% of the infant losses were to African-American mothers
  • 88.3% of the mothers headed single parent households
  • 87.3% were on Medicaid at the time of their infant’s death
  • 59.2% of the mothers were overweight or obese during their pregnancies
  • 63% had inadequate prenatal care
  • 38.8% smoked during their pregnancies
  • 8.7% consumed alcohol during their pregnancies
  • 25.2% used recreational drugs during pregnancy

Categories of infant death (103) in this study

  • 47 died prenatally (prior to birth)
  • 57 died after birth from the following causes
    • 31 died of complications of prematurity
    • 7 died of chromosomal defects or congenital anomalies
    • 3 died of Sudden Infant Death Syndrome (SIDS)
    • 7 died of unsafe sleeping conditions
    • 9 deaths were attributed to perinatal factors and other reasons

Infant Mortality Rates measure the risk of dying during the first year of life

Healthy People 2020 IMR (target goal)                  6.0/1000 live births

National IMR (2005, CDC)                                      6.7/1000 live births

Missouri IMR (2008 data)                                        7.2/1000 live births

Kansas City IMR (2008 data)                                  8.2/1000 live births

Conclusions from this study (from Uzazi Village, not the study authors):

  • African-American infants in the urban core are dying at higher rates than the general population
  • Most of those deaths are related to complications from prematurity
  • There are a lot of social and physical determinants of health that need to be addressed in a way that is population specific
  • The women at highest risk for fetal/infant loss are less likely to utilize prenatal care
  • (The study did not look at these factors but sexually transmitted vaginal infections (chlamydia and gonnorhea) and hemoglobinapathies (such as Sickle Cell Anemia), and hypertension can all be risk factors for preterm labor and delivery and are likely to be increased in African-American women)