The Missouri Foundation for Health (MFH) released a report last week that outlines health disparities that exist between the state's black and white populations.
"African-Americans lag behind whites in many health indicators and overall determinants of health which factors things such as where we live, genetics, income and education level, relationships with family and friends and our environment," said Marie Peoples, director of the Cole County Health Department. "Numerous factors impact our physical and mental health."
According to the report, nearly 78 percent of the state's black population resides in St. Louis County, St. Louis City and Kansas City. The next largest concentrations of blacks live in St. Louis and Kansas City suburbs, Cape Girardeau, Springfield, Columbia and Jefferson City.
The Bootheel region and the central part of the state are additional hot spots for black health disparities.
"Of the health disparity data, the most concerning is the gap between healthy outcomes for pregnant women and for infants and children," Peoples said of Cole County's data. "African-American women in Cole County are less likely to seek and receive prenatal care when compared to white women."
According to the report, data analyzed from 2006-10, the rate of black mothers with inadequate prenatal care in Cole County is more than triple the rate for white mothers. For every 100 live births, 29.7 black mothers received inadequate prenatal care compared with 9.2 whites.
The statewide rate of black mothers with inadequate prenatal care is more than double the rate of white mothers.
The report defines inadequate prenatal care as "fewer than five prenatal care visits for pregnancies shorter than 37 weeks gestation, or fewer than eight prenatal care visits for pregnancies 37 or more weeks gestation, or prenatal care that began after the first four months of pregnancy."
Peoples said there are many barriers to receiving prenatal care, including education, transportation, insurance, a lack of physicians that accept Medicaid and family support.
"Taking a multi-vitamin that contains folic acid is another indicator that African-Americans in Cole County lag behind in," she said. "Folic acid intake significantly reduces neural tube defects among newborns."
Another health disparity relating to maternal and child health for blacks in Cole County is infant death, which according to the report is "deaths of resident babies who were born alive but died during the first year of life."
The infant death rate for blacks in the county is nearly triple the rates of whites. The state rate is more than double.
The county rate for black infant deaths is 16.8 deaths per 1,000 live births compared with 5.3 white infant deaths per 1,000 live births.
Peoples said the Cole County Health Department is working to lessen or eliminate the disparities.
"Our goal is to be preventive rather than reactive," she said. "We are currently offering a preconception health program through the Missouri Foundation for Health grant that targets women of childbearing age, regardless of race."
She said that through the funding of a full-time healthy living coordinator who collaborates with community agencies across the county, the department educates women and their families on the importance of healthy lifestyles prior to beginning a family.
The lifestyle practices include education on tobacco, alcohol and other drugs, nutrition and wellness.
Peoples said the department's WIC program also helps women and children.
"The WIC program does more than provide supplemental nutrition to women and children with qualifying incomes," she said. "The WIC program provides nutritional support and education, lactation education and pumps, support groups and many other resources."
The Cole County Health Department also collaborates with the Community Health Center of Central Missouri (CHCCM) by placing a center staff person at the department.
"When a woman is identified as being pregnant, she immediately receives prenatal education and assessment from nurses and then is connected to the CHCCM staff person to assist with locating and making an appointment for prenatal care," Peoples said. "This collaboration ensures pregnant women enter the prenatal care and immediately begin taking a multi-vitamin."
She said the health department also offers asthma management, diabetes and nutrition education to help reduce negative chronic disease outcomes.
MFH works with organizations, like the Cole County Health Department, to address health disparities around the state.
"There's a push for us to get out into communities who are seeking partners," said Ryan Barker, vice president of health policy for the MFH. "Access is a big part, and a lack of health care and primary care are other components."
The Foundation is "dedicated to improving the health of people in our region ... and works as a changemaker, educator and partner to promote community health and increase access to care for the uninsured and underserved."
Parts of the organization's strategic plan, as well as grants it gives to community organizations, target health disparities in communities and statewide.
"We need to start talking about some of these issues and start finding solutions," Barker said.