MANSFIELD, Ohio—Although the U.S. health care system is the most expensive in the world, the country has some of the worst birth outcomes across the globe. Moreover, Ohio is ranked 47th overall for infant mortality and 50th for African American infant mortality.
These alarming statistics were brought to the county commissioners’ attention Tuesday morning by Drs. Mark and Sarah Redding, founders of the Community Health Access Project (CHAP) of Mansfield.
The husband and wife team have had a hands-on approach to helping find a solution to infant mortality and low birth weight babies. They conducted a study through the CHAP program that included 116 pregnant CHAP clients and demonstrated more than 60 percent reduction in low birth weight and more than 500 percent return on investment when comparing program cost to avoided health care, special education, and societal cost associated with low birth weight babies.
The study was first requested by then state Sen. Bill Harris 14 years ago to evaluate the effectiveness of the CHAP program in combating low birth weight. Through Harris' legislative work, the CHAP home health care specialist is now a recognized medical job position in Ohio.
CHAP set out to impact infant mortality and low birth weight based on experience and research gathered in Alaska. In the 1940s, Alaska had the worst infant mortality in the U.S. and now the state has the lowest.
CHAP has focused on census tracts in Richland County with the highest rates of low birth weight. Targeted census tracts had low birth rate as high as 23 percent.
In partnership with local obstetricians’ offices, CHAP developed the care coordination plan of care using the Pathways Model. Pathways are tools used to make certain that each health, social and behavioral health risk factor identified is addressed with evidence-based or best practice intervention.
Following scientific study protocols, CHAP worked in partnership with the Ohio Department of Health, Centers for Disease Control and Prevention and The Ohio State University to study the impact.
“What’s fascinating is that it’s a very addressable issue,” Mark Redding said.
He noted that the outcome of low birth weight and infant mortality is not just related to accessibility of medical care. “It’s actual even more so affected by things like housing, food, clothing, adult education…” he said.
Health Commissioner Martin Tremmel, who was present at the meeting, said that low birth weight and infant mortality commonly stems from improper prenatal care.
“It’s not simply access. It’s making sure that we as a community wrap our arms around moms as early as we can and get them into prenatal care,” he said.
“Taking care of your baby starts the moment you know that you’re pregnant…Unfortunately, because of a number of societal reasons, some folks think that when you take care of your baby that starts the day that you have the baby.”
Sarah Redding added that there needs to be a comprehensive approach to helping pregnant individuals by ensuring that every risk factor is addressed.
“Everyone is unique, so we can’t just say there is one solution for everybody,” she said.
Describing their work, Mark Redding said, “In its simplest form, we’re reaching those most at risk, [workers] are identifying their multiple risk factors (health, social, behavioral health), and then we’re making sure those risk factors are addressed, and we’re measuring the results.”
He said that CHAP and the local hub services do not provide the direct medical service. “We simply identify what’s needed and then make sure those packages of intervention are delivered, so it’s a little bit like UPS,” he said.
Original funding for the CHAP program was provided by the Richland County commissioners through the Department of Job and Family Services in 1998. CHAP later became an affiliate agency of United Way of Richland County and has also received financial support from the Richland County Foundation.
“Our most important component of this meeting,” Mark Redding said, “and what we’d like to accomplish today is just to say ‘thank you.’”
“Even if nobody does anything with it, because of what you guys did, there are a bunch of little 9 and 10 year olds that have bigger brains that are working better and aren’t in wheelchairs, aren’t in long-term care facilities racking up millions of dollars.”
However, they hope to continue gaining momentum by seeking out opportunities to present their research findings to Gov. John Kasich.
“The thing we have to knock on [Kasich’s] door harder with is this new, credible research,” said Mark Redding. “And it’s small; it’s not like a big, multi-state study, but it’s actually the only one in this whole area of work.”