Millions in Federal Funding Support: Morgan State-led Public Health Research to Curtail Health Problems Among Black Mothers, Infants (Reprint from the Morgan University Website)

Bridging the Divide in Maternal and Child

Health

Black maternal and infant mortality is increasing at an alarming rate despite increased spending and 21st-century advances in healthcare. The numbers decry a painful truth: according to the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH), for instance, Black infants are nearly four times less likely to survive because of complications related to low birth

weight, and Black mothers are twice as likely to receive late or no prenatal care.

These and other figures present a stark reality for Black families who are poised

for parenthood yet struggle with unseen odds that place the lives of both mother

and child in the balance.

In confronting these harsh statistics, unraveling the complexities of factors

contributing to the disparity has become crucial for the Black community, which is

grappling with a disconcerting incidence of maternal and infant mortality that

demands urgent attention and meaningful solutions.

“There is overwhelming evidence from (the National Institutes of Health and the

Centers for Disease Control and Prevention) that greater than 60% of the cause of

maternal and infant mortality involves the social determinants of health,” said

Yvonne Bronner, Sc.D., professor of Public Health at Morgan State University and

principal architect of the integrative research taking place at Morgan that’s

examining the non-medical structural forces driving inequity in maternal health.

The Health Resources and Services Administration (HRSA) has committed more

than $50 million in support of the White House Blueprint for Addressing the

Maternal Health Crisis: a critical investment to help stem the increased rates at

which women in the United States are dying from pregnancy-related causes —

rates higher than in any other developed nation and disproportionately higher

among Black women.

Public health researchers at Morgan are standing on the frontlines to examine these

occurrences, better understand their origins, and illuminate pathways toward a

healthier and more equitable future for Black mothers. Their work involves an

expansive, community-based research initiative that will create a blueprint for

Black communities nationwide.

Within the last year, Morgan State's School of Community Health and Policy

(SCHP) and the University’s Center for Urban Health Equity (CUHE) have

secured more than $15 million in federal grants supporting a number of initiatives

with one common thread: maternal and child health equity.

“We are excited about this level of funding, what will come and what it means for

HBCUs and communities across the country,” said Kim Dobson Sydnor, Ph.D.,

Dean of the School of Community Health and Policy at Morgan. “This work has

been prioritized, and Morgan has made a very intentional, strategic effort to be the

foremost authority in addressing the longstanding inequalities Black and brown

women disproportionately face. The culmination of this funding and the research it

will support are truly a defining moment.”

Creating a Public Health Coalition

A significant stride toward Morgan’s goal to significantly reduce the incidence of

Black maternal and infant mortality came with a transformative federal investment

establishing the framework for a first-of-its-kind public health coalition. 

Morgan will serve as the coordinating center and is charged with coalescing 16

research centers housed in minority-serving institutions nationwide, including one

at Morgan, in an intensive public health research that will examine the root causes

of mortality disparities between Black and other communities. The five-year, more

than $11-million HRSA grant, “Maternal Health Research Network for Minority-

Serving Institutions,” focuses on enlightening, educating and igniting “a paradigm

shift” in maternal health research rooted in community engagement.

Unique to this initiative and its funding are the awarded institutions. According to

Dr. Bronner, Historically Black Colleges and Universities (HBCUs) and minority-

serving institutions (MSIs) have long played ancillary roles supporting

predominantly white institutions in maternal and infant research.  The Morgan

team with the support of CUHE led the establishment of the HBCU Alliance Team

for Maternal, Child and Family Health (HAT) consisting of partner institutions,

Morehouse School of Medicine, Tuskegee University, Tennessee State University,

Texas Southern University and Chicago State University and the HAT has been

instrumental in advocating for the investment in our HBCUs.

“(HAT) will allow us to move these institutions forward in increasing their

maternal health research capacity while sharing lessons learned with our unfunded

institutions,” Bronner added.

Leveraging the expertise and efficacy that HBCUs have cultivated as anchor

institutions in the Black community is paramount to the effort. Many of the causal

factors of the health disparities are rooted in many social determinants of health,

and researchers have limited evidence examining the relationship between social

and structural determinants of health and maternal and infant mortality.

The disparities are systemic and will require a multifaceted, cross-disciplinary and

long-term approach that will encompass a phased, 15-year commitment to yield

progress in leveling the rates of maternal and child mortality, Bronner said.

“We’re currently in the capacity-building and strategic planning phase,” Bronner

said. “By year three, implementation will be in full swing, and within the next five

years, the ‘bottom-up,’ community-engaged, problem-solving curriculum and

research will be established, which will allow full devotion to competitive

sustainability.”

A Multifaceted Approach to Making an Impact

Public health researchers at Morgan are tackling maternal and infant health through

nationally scoped, long-term strategies and grassroots efforts designed to address

several immediate needs. 

“Dr. Bronner had a vision for a national maternal child health agenda, and she is

seeing it through, along with contributions from many other Morgan public health

researchers who are making a critical impact in this meaningful work,” said Dean

Dobson Sydnor. “I am extra proud today, as Dean of SCHP, and also happy to say

that the Center for Urban Health Equity was able to support the work it took to

earn these awards.”

Complementing the efforts of the national coordinating center, Morgan was funded

for a five-year, $3-million research center grant to combat maternal mortality and

improve maternal health, particularly in underserved communities in the Greater

Baltimore region. Kesha Baptiste-Roberts, Ph.D., M.P.H., associate professor and

chair of the Public and Allied Health Department in the School of Community

Health and Policy, serves as the grant’s principal investigator.

Paramount to the effort will be building a framework and community-based

network for maternal health exploration and study, maternal healthcare workforce

expansion, greater accessibility to maternity services, and treatment of postpartum

maternal health issues, in marginalized communities.

“We are currently collaborating with our state and local health departments, and

national partners such as the Black Women's Health Imperative, Baltimore Healthy

Start, Light Health and Wellness, MOMCares, to name a few,” shared Dr. Baptiste-

Roberts.

Elaborating on Morgan’s effort to bring together a grassroots network of partners

and participants successfully, Baptiste-Roberts does not anticipate challenges with

recruiting and engaging research participants in the research projects. 

“Our School of Community Health and Policy is rooted in the community. We

have a history of successful collaboration and true partnership with the

community…(and we) strive to engage in research that is community-informed,

community-engaged and focused on solving problems and improving the health of

the community.”

Another component of this effort is a CMS-funded grant focused exclusively on

researching the impacts of employing the doula mode of care to reduce maternal

and infant mortality among underserved Black and brown women. Investigators

led by Marilyn Berchie-Gialamas, D.N.P., C.R.N.P., NP-C, assistant professor in

Morgan State’s Department of Nursing, and principal investigator for the doula

research project, will conduct focus groups of diverse women living in Baltimore

who have had a live birth within the past two years, in-depth follow-up interviews

with the cohorts of focus group participants, and engagement with doulas who

have served for at least two years in the Baltimore area.

As indicated in a 2022 HHS Office of Health Policy report, the work of doulas has

been beneficial in maternal health. Doula’s support during pregnancy and birth and

their advocacy for patient autonomy — particularly for Black women — have been

shown to be effective in improving the labor and delivery experience and in

mitigating health disparities within underserved groups. The NOURISH program, a

full spectrum community doula program for college students developed by the

Black Women’s Health Imperative, was piloted at Morgan with 40 students who

are now serving their communities.

“Our approach of employing a focus group model to engage and obtain accounts of

mothers and doulas will allow our field researchers invaluable examination of and

insight (into) the impacts doulas offer throughout the entire pregnancy,” said Dr.

Berchie-Gialamas.

Over the next several months, Morgan and its School of Community Health and

Policy will be the epicenter of maternal and child health equity research activity.

From the HBCU Alliance Team of Research Centers providing a presence

nationally to the grassroots efforts deepening Morgan’s engagement in the greater

Baltimore community, there’s no shortage of human capital committed to this

effort. And now there’s a financial commitment at the federal and state level to

match.

The need for such research is undeniable. Maternal and infant health are

fundamental indicators of a society’s well-being, yet disparities persist, claiming

lives during times when families should be celebrating the fullness of life and joys

of maternity.

“We want to tell the untold story of a healthcare divide that demands our attention

and collective commitment to rewrite its script for a healthier, more equitable

future,” added Dean Dobson Sydnor. “Our legacy as public health educators,

researchers and practitioners is to end this cycle of inequity. That is our mission.”