Perinatal Equity Initiative (PEI)
California Perinatal Equity Initiative (PEI) is a community-driven and implemented initiative designed to address racial disparities in infant mortality by providing meaningful support and resources to Black families. While California is experiencing a decline in infant mortality, the statewide mortality rate for Black infants continues to be about two to four times higher than rates for other groups. The California Department of Public Health created PEI to address these disparities and improve health outcomes. PEI complements programs and services offered through the Black Infant Health (BIH) Program to further enhance impact and promote health equity.
Program Profile
OUR GOAL: To improve birth outcomes and reduce mortality for Black infants through county-level approaches that are evidence-based, evidence-informed or reflect promising practices.
WHO WE SERVE: Pregnant and parenting Black women and their partners, through the first year of their child’s life.
SERVICE DELIVERY: PEI strategies will be evaluated utilizing the Results -Based Accountability (RBA) framework.
OUTCOMES: PEI strategies will be evaluated utilizing the Results -Based Accountability (RBA) framework.
RBA is a methodological approach that allows local communities, in real time, to evaluate and respond to the impact of intervention efforts by making adjustments to the strategies as needed. Counties with similar strategies will be developing common (shared) performance measures that will be integrated into one evaluation instrument. Shared accountability means shared learning and shared commitment to reduce perinatal disparities in California.
FUNDING: PEI services are financed by State General Funds.
PEI supports eligible local health jurisdictions in the implementation of specific strategies that have shown evidence-based (or evidence-informed) promise in reducing racial health disparities in birth outcomes among Black women. These strategies include:
Group Prenatal Care includes improvement in health provider preterm birth screening and ongoing risk-appropriate care for Black women that better predicts the risk for, and helps prevent, preterm births.
Pregnancy Intentionality, Preconception and Interconception Care is designed to increase women's health by focusing on their ability to make informed decisions about if and when they become pregnant, and their health-affirming behaviors both prior to conception and between pregnancies.
Fatherhood or Partnership Initiatives that promote the importance of having partners engaged in the process, bolstering mental, emotional and physical health both during pregnancy and post-delivery.
Home Visitation Programs that assess and empower women by connecting them to programs for prenatal care, monitoring, life planning, birth spacing, infant development, doula services and more.
Innovative Strategies not listed above that demonstrate evidence-based success in reducing adverse birth outcomes, like personalized case management, integration of mental health services in perinatal health care, doula services, and other wrap-around services.
Each PEI site will participate in learning collaborative cohorts to support implementation of the interventions they have selected. Counties implementing similar interventions will be grouped together, providing them the opportunity for shared learning and alignment to best address infant mortality. The learning collaborative meetings are not open to the public and will be held every other month. The interventions counties are implementing can be found below:
| Intervention |
PEI Local Health Jurisdictions |
|---|---|
| Doulas/Midwifery |
Alameda Contra Costa Fresno Riverside Sacramento San Bernardino |
| Group Prenatal Care |
Alameda Los Angeles |
| Fatherhood/Partner |
Contra Costa Fresno Los Angeles Riverside Sacramento San Bernardino San Diego San Joaquin |
| Personal Support |
San Joaquin Santa Clara |
| Home Visiting |
San Francisco |
| Preconception/Interconception Care |
Los Angeles Sacramento Santa Clara
|
| Implicit Bias |
Alameda Los Angeles San Bernardino San Diego San Francisco |
- Health disparities affecting Black women and babies appear to be less dependent on age, economic status or education.
- Poor birth outcomes persist even when Black women have a pregnancy at an optimal age, have high income or are well educated.
- Black women are four to six times more likely to die from pregnancy-related causes than Asian/Pacific Islander, Hispanic/Latina and White women.
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- Black babies are twice as likely to be born with a low birth weight (less than 5 lbs., 8 oz.) than infants of other racial or ethnic groups.
2
Graphic chart above is a representation of surveillance data.3 For actual data contact:
MCAHDataHelp@cdph.ca.gov References
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California Pregnancy Mortality Surveillance System, Pregnancy-Related Deaths 2008-2016
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State of California, Dept. of Public Health, California Birth Statistical Master File, 2017
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California Birth Cohort Files, 2000-2016; Prepared by the Epidemiology, Surveillance and Federal Reporting Branch, Maternal Child and Adolescent Health Division, Center for Family Health