A BIRTH RECORDS ANALYSIS OF THE MATERNAL INFANT HEALTH ADVOCATE SERVICE PROGRAM: A PARAPROFESSIONAL INTERVENTION AIMED AT ADDRESSING INFANT MORTALITY IN AFRICAN AMERICANS

Recognizing that no single intervention was likely to eliminate racial disparities, the Genesee County REACH 2010 partnership, utilizing both ``bench' ' science and ``trench'' knowledge, developed 13 broad-based, multi-faceted interventions to eliminate infant mor-tality. This article provides highlights from a re-cent birth records comparison analysis of the Maternal Infant Health Advocate Service (MI-HAS) intervention, and is solely based on the records of 111 MIHAS clients, and a random sample of 350 African-American women resid-ing in Flint, Michigan. The MIHAS clients were more likely than the comparison sample not to have graduated from high school (56 % vs 35%, respectively, P,.0001). The MIHAS clients were more likely to report at least some smok-ing during pregnancy (20 % vs 15%, respective-ly, P,.05). However, after controlling for age and education, these results were no longer statistically signi®cant. In terms of birth out-comes, the comparative odds of MIHAS clients delivering a low birth-weight infant are 1.124 (95 % CI: 0.620±2.038); the odds of their de-livering an infant at 37 weeks or earlier are 1.032 (0.609±1.749). Although the MIHAS cli-ents did not have statistically better birth out-comes than those of the general African-Amer-ican population in Flint, the MIHAS clients did not demonstrate the outcomes one would ex-pect, given their higher level of risk. Based on this analysis, the MIHAS intervention may have brought its clients ``up to par' ' with the general community on several birth outcomes. (Eth