Video by Kyra Gurney and Simone McCarthy
A significant disparity in the health of New York City’s babies exists. While the city’s infant mortality rates are at an all-time low, the most recent city statistics show wide gaps in infant health across socioeconomic lines. One stark example: eight infants die for every 1,000 black babies born; yet only three do for every 1,000 whites babies born. The same data shows that areas with low access to prenatal healthcare and poor infant health outcomes are also those with high rates of poverty.
The Nurse-Family Partnership, a program based on a model started in the 1970s by medical professor David Olds of the University of Colorado-Denver, is trying to improve the health of mothers and their babies. In the highly vetted program, specially trained nurses visit first-time, Medicaid-eligible mothers in their homes from the time of pregnancy until their child is two years old.
Nurse-Family Partnership launched in New York City in 2003, and the Department of Health and Mental Hygiene now funds seven Nurse-Family Partnership sites across the city, serving nearly 1,800 new moms. In addition, Montefiore Medical Center has its own Nurse-Family Partnership.
By coming directly to the home for visits, the program’s nurses are able to keep a continuity of contact with mothers, who might otherwise get infrequent care, according to the New York City Nurse-Family Partnership director, Roberta Holder-Mosley.
“Our clients are poor, quite poor, the employment rate for our clients is relatively low. They are on the fringes of the society,” said Holder-Mosley. And apart from increasing access to healthcare, she said, the program “helps to break the cycle of poverty.”
During their monthly visits, nurses track both the mothers’ and babies’ health, but also focus on the mother’s personal goals and her path toward economic stability.
“A lot of the first year is just learning survival skills, how do I do this?” said Joanne Schmidt, who has been a partnership nurse for seven years. “Babies are not cheap, they’re very expensive—just being able to afford diapers and being able to handle needs, formula, food in the house and taking care of those basic, basic things that you need to survive. That’s a huge deal now. How do I afford this?”
In their home visits, nurses are able to evaluate the environment and safety for mother and child. In some situations, they identify dangerous situations and deal with tragedy.
“We have had babies die. We have had babies removed from mother’s care where actually the nurse had to initiate the call,” said Holder-Mosley, explaining that nurses are mandated reporters to Administration for Children’s Services.
These are the situations that the program exists to prevent, and decades of data collected from the program across the country show its benefit. Those who participate have nearly 50 percent fewer cases of neglect and abuse than families that do not. And at age six, two-thirds of children who participated as babies have fewer emotional and behavioral problems than their peers who did not. Holder-Mosley also sees a great impact on the mothers.
“Many of the clients talk about the fact that their nurses are their role models,” she said. Many of them have said they want to become certified nursing assistances, partnership nurses or registered nurses. Those successes, she said, along with healthy babies, are what the program is all about.