Indiana has historically had one of the worst infant mortality rates in the country, but the state is making progress. In 2019, Indiana saw its largest drop in infant mortality in six years. CareSource Indiana is capitalizing on that momentum, putting more focus on Hoosier moms and babies than ever before. CareSource says health disparities, which have become even more evident during the pandemic, are major contributing factors to infant mortality, so the nonprofit health program is attacking the problem from a multitude of angles.
Based in Dayton, Ohio, CareSource is a multi-state nonprofit health plan with about 200,000 members throughout the Indiana; it’s one of the nation’s largest Medicaid managed care plans.
“We’re at the forefront of addressing health disparities; we recognize that, unfortunately, not everyone has the same risk, and we need to recognize who’s at increased risk,” says CareSource Indiana Vice President and Market Chief Medical Officer Dr. Cameual Wright. “We need to have conversations—which sometimes are difficult—about the drivers of those risks. CareSource recognizes that and is fearlessly moving forward in the direction of helping mitigate those disparities.”
The state’s infant mortality rate is 6.8%, more than a full percentage point higher than the 5.7% national rate. About three-quarters of the infant deaths in Indiana are in Marion and Lake Counties, which Wright says emphasizes the close connection between infant mortality and health disparities.
“The infant mortality rate for black babies is about twice that of white babies, so it’s about 13%. [Lake and Marion] counties have a high population of black and brown women, and we know those populations have a higher infant mortality rate,” says Wright. “That highlights the fact that in these urban areas, we really need to make sure that women have access to resources, feel they’re being heard and are respected by their practitioners, and that they’re educated about all the things they can do to reduce infant mortality.”
Wright says CareSource is aiming to reduce infant mortalities by focusing on its drivers: low birth weight, pre-term deliveries and lack of prenatal care.
“We want to link arms with our pregnant members, educate them during pregnancy and help ensure they’re getting prenatal care as early as possible and on a consistent schedule,” says Wright. “Timing is important; pregnancy outcomes are improved if prenatal care begins in the first trimester, so we’re trying to identify our pregnant members as soon as possible.”
CareSource is also working to address two other key drivers of infant mortality: smoking and lack of breastfeeding. The health plan offers counseling and financial incentives to stop smoking and promotes breastfeeding with individual moms, as well as reaching wider audiences with Bumps and Babies Family Resource Fairs in counties with higher infant mortality rates.
CareSource works closely with the Indiana State Department of Health to battle infant mortality. The nonprofit is partnering with the state’s My Healthy Baby program, which the state says is having a particularly successful year, despite the pandemic. The program, which focuses on home visits, launched in 22 counties and is on track to add 23 more counties.
“Studies show the most the sensitive predictor of the health of a community is actually the health of its infants and the infant mortality rate,” says Wright. “If the infant mortality rate is high, then chances are there’s room for improvement in the overall health of the community. Likewise, if you want to improve the health of your community or a particular population, you want to start by addressing the infant mortality.”
The pandemic exposed just how impactful health disparities can be; people of color experienced higher Covid death rates than white populations. Wright says CareSource will continue to “push the envelope” to level the balance, with the ultimate goal of delivering health equity to the youngest patients in the Hoosier state.
Wright says one of the biggest challenges CareSource is currently facing is getting pregnant woman vaccinated against Covid.
Wright says CareSource is aiming “to think outside the box” to address social determinants of health.