The Florida Department of Health in Pinellas County (DOH-Pinellas) serves over 975,000 residents in a county situated on the West coast of Florida. DOH-Pinellas offers a range of services, including Clinical Health, School Health, Maternal Child Health and many others. The Maternal Child Health Division includes evidence-based programs such as Healthy Families, Nurse-Family Partnership, WIC (Women, Infants and Children) and Healthy Start. The Public Health Accreditation Board has accredited DOH-Pinellas as part of a statewide integrated health system since 2016. The department prides itself on its many community collaborations and for being a trusted resource for individuals and entities served. Some of the department's community collaborations and partners include Health in All Policies, Foundation for a Healthy St. Petersburg, Healthy Start Coalition of Pinellas County (HSC) and the Juvenile Welfare Board of Pinellas County (JWB). The department's community collaborations assist in enhancing all services provided to Pinellas County's population. In Pinellas County, approximately 83% of the population identifies as White, 11% Black and 10% Hispanic. Approximately 54% of the population is over the age of 45, while only 4% are 0-4yrs of age with the population under 24yrs decreasing by 3% based on the 2010 census. Recent data based on local hospital birth reports show steady declines in birth rates in the county since 2016.
DOH-Pinellas strives to serve a largely aging community while also providing needed services to an increasingly diverse population. For example, health equity has become a lens that the department looks through when creating new programs. This has enhanced conversations throughout the department and, as a result, collaborations have grown and flourished.
Adding the health equity lens to the discussion of infant mortality has highlighted the severity and complexity of addressing the issue. However, it has also brought an impressive array of community organizations to the table to take a comprehensive approach to this problem. A 2019 Tampa Bay Times article summarizes that health equity is a key risk factor affecting infant mortality. The article uses direct quotes from the Pinellas County Medical Examiner's Office to report that several risk factors associated with infant mortality, include the infant's gender, race, gestational age and environmental exposures. (Lane DeGregory article, Tampa Bay Times, 12/11/2019).
To address this issue the Juvenile Wellness Board (JWB), a primary funder of the Healthy Families Pinellas program and many other child-centered prevention programs in the county, established the Preventable Deaths Campaign. In reviewing preventable child deaths for the county, it was determined that in the last ten years, 76% of preventable child deaths between 2011-2019 were infant sleep-related, 17% were drowning-related and 7% were a result of inflicted head trauma. Members of the committee identified that families of infants who died before their first birthday were not enrolled in parent education or home visitation programs. It was thought possible to provide the basic education surrounding these topics to parents without the commitment of enrolling and engaging in a program. Further, it was hoped that ensuring all parents in the community receive education and resources to address those three significant causes of child death would decrease the mortality.
In Pinellas County, 50% of eligible families with infants are enrolled in the Pinellas WIC program. Since both WIC and Healthy Families are housed in the Maternal Child Health (MCH) Division of DOH-Pinellas, JWB funded an intra-agency collaboration to address the three leading causes of infant deaths in Pinellas County. Three Safe Baby Educators were hired and co-located full-time in three different WIC offices in the county. Embedded into the WIC process, caregivers are referred to the Safe Baby staff while going through the WIC clinics. Meeting with the Safe Baby staff is a voluntary activity for families. When they meet with the Safe Baby Educators, they receive educational materials to take home on safe sleep, choosing caregivers and Shaken baby syndrome. Educators meet with families for about 10-15 minutes each. Initial program objectives were to provide education to 2,500 caregivers. In the first year, starting July 2019, educators saw 2,609 caregivers.
One of the main factors in the success of this program is its simplicity. Educators request minimal information from the caregiver before disseminating educational materials and potentially a Pack ‘n Play. Time is allotted to the original appointment, so that no additional time needs to be requested for these services. Additionally, this program uses a well-defined, curriculum that is targeted and easy for families to understand.