By Molly M. Ginty
Tuesday, May 5, 2009
Unlike compartmentalized programs, the Developing Families Center in Washington D.C. brings social and medical services under one roof--and offers better outcomes for the predominantly African American community it serves.
(WOMENSENEWS)--A buckling floor. A sagging roof. Dust motes floating in shafts of sunlight.
When Ruth Watson Lubic first saw the remains of an abandoned grocery store in Washington, D.C., she knew she could turn it into the maternal health center she envisioned, if she took it one task at a time.
More than a decade later, working step by step is how Lubic and her colleagues continue to approach mothers' and infants' health at the facility they created: the Developing Families Center, whose clients are mostly African Americans from impoverished northeast D.C.
The center's stated goal is simple: "healthy babies, healthy women and healthy families."
It's a comprehensive approach--and a rare success story. Studies show that compared to other African Americans in D.C., clients at the Developing Families Center have one third the rate of preterm birth (7 percent versus 24 percent) and half the rate of low birth weight and C-section (6 percent versus 14 percent and 13 percent versus 32 percent). Compared to black mothers nationwide, they are 30 percent more likely to try breastfeeding.
"Our facility is the only model of its kind," said Dr. Linda Randolph, Lubic's business partner and president and CEO of the Developing Families Center. Dr. Randolph is being honored as a Women's eNews Leader for the 21st Century Thursday in New York City. "Other health entities may have social services, but they are usually more medically-oriented. We seek not just to treat health problems, but to solve them by addressing their root cause."
African American infants are twice as likely to be born prematurely, to be of low birth weight and to die before their first birthdays as babies of other ethnicities, according to the Atlanta-based Centers for Disease Control and Prevention.
Black women are three to four times more likely than white women to die during pregnancy and are more likely than any other group to deliver via C-section, which lengthens recovery time and boosts the risk of blood clots, infection and hysterectomy. Black women are also twice as likely to not follow government health guidelines and to not breastfeed exclusively for the first six month of an infant's life.
Studies show health outcomes for black mothers and children are even worse in D.C. than they are in the rest of the United States. But regardless of where these disparities occur, health advocates cite racism, poverty, inadequate maternal nutrition, medical discrimination and poor access to prenatal and infant care as their underlying causes.
Lubic, an 82-year-old nurse-midwife, spent the 1970s and 1980s launching two freestanding birth centers in New York City, and then helped to create 200 others across the United States.
When this won her a $375,000 MacArthur Foundation "genius" grant in 1993, she decided to use the money to address health problems plaguing black women and children in D.C.'s Ward Five, a longtime hotspot for racial disparities.
She hoped to create a one-stop center where families could get all the medical care they needed--and to get it in a revolutionary way: at one central site so access was not a problem; in a loving, supportive environment devoid of discrimination; and coupled with the social services they needed such as counseling and food provision.
Lubic enlisted the help of Randolph, the former director of New York State's Office of Public Health and a 2009 recipient of the Women's eNews 21 Leaders for the 21st Century awards on May 7.
Sixty other staff members joined them in their efforts. Together, they used grant funding, government support and a clear, united vision to make Lubic's dream a reality. Since the $2.1 million renovations were completed in 2000, the Developing Families Center has boosted its clients' breastfeeding rates--and lowered their C-section, low birth weight and preterm birth rates--by 50 percent.
The facility's supporters attribute its success to its comprehensive approach. Here, three agencies collaborate under one roof to provide continuous services to families in need.
At the $1 million Healthy Babies Project, clients attend counseling, parenting, yoga and life skills classes; wash their clothes in a laundry room; and pick up groceries from a food pantry.
At the $2 million Family Health and Birth Center, they receive physical exams, family planning services, and prenatal care and immunizations. Seventy percent of the program's pregnant clients deliver at Washington Hospital Center two miles away, while 30 percent deliver in two free-standing birth rooms here.
At the $2 million United Planning Organization Early Childhood Development Center, laughter rings through six child care and preschool rooms. Children ages six months to two years romp--then rest--among cubby holes brimming with books, blocks and stuffed animals
Together, these programs serve a total 1,000 families per year, a fivefold increase in volume since the Developing Families Center opened.
"Because all three agencies are working with some aspect of a mother's life, we can support each other--and her--in our efforts," said Lisa Uncles, the birth center's director of midwifery. "If a birth center client doesn't have healthy food, the healthy babies program provides it. If she needs daycare for her children, she can find it here."
In the future, the Developing Families Center hopes to expand its services. "We'd love to provide primary health care, a wellness center, and dental and mental health services," said Randolph. "Our ultimate aim is to add a second story to our building."
Financing the expansion could prove challenging as the recession deepens and as expenses (from a $40,000 waterproofing bill to $300,000 in annual malpractice premiums) continue to mount.
Even so, expansion could save money in the end. "When mothers are encouraged to take charge of all aspects of their health, they have lower preterm birth, C-section and low birth weight rates," said Lubic. "Because our care is preventative, we save $1.2 million in added health care costs for every 150 births we handle. If you apply that to the 1.7 million births that Medicaid handles each year, that means Medicaid could save $12.8 billion annually if it adopted our comprehensive model."
Molly M. Ginty is a freelance writer based in New York City. For information on the book she is writing about racial disparities in health outcomes, please email her at firstname.lastname@example.org.
D.C. Developing Families Center
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