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Pilot program aims to reduce infant deaths

Mayor Thomas M. Menino and Naralis DeJesus at a press conference announcing the program yesterday.John Tlumacki/Globe Staff/Boston Globe

In an effort to drive down the disproportionately large number of deaths among black and Latino infants in Boston, city leaders yesterday unveiled a campaign to provide housing, counseling, and other critical support for pregnant women who are homeless or living on the edge.

The pilot program, believed to be the first of its kind in the country, will initially make 75 Boston Housing Authority apartments available for little or no charge to women living on the streets, in shelters, or sleeping on couches and floors of family and friends. Those facing eviction or domestic violence may also qualify.

The city’s health commission will provide visiting nurses and counselors to help these women navigate the demands of motherhood and get health care for their families.


“For the past two decades, black women in Boston . . . have been two to four times more likely than white women to lose their babies in the first year of life,’’ Barbara Ferrer, the Boston Public Health Commission’s executive director, said during a news conference at Boston Health Care for the Homeless.

The city’s latest data show significant progress in narrowing the gap among infants of color, and the new initiative is aimed at turning that one-year improvement into a sustained trend.

In 2009, the black infant death rate was 7.7 for every 1,000 births and the Hispanic rate was 8.0, while the white rate was 5.0.

Ferrer said that emerging science indicates that chronic stress on pregnant mothers, particularly associated with poverty and racism, can adversely affect the health of their babies. And one of the key sources of stress, she said, is anxiety over housing.

“We have heard, year after year from the women we serve and our community partners that housing is one of the leading causes of stress for low income pregnant women in Boston,’’ she said. The commission does not have data on how many infant deaths occurred among children of homeless women.


The program will provide counseling and support for the first 18 months after a woman gives birth, while the public housing placement will be permanent, she said.

The women will be selected based on income and need, and the program will be open to all Boston residents, regardless of race.

City data indicate that women of color are more likely to have complex health problems, which put them at risk of having complications during pregnancy and infants with low birth weights. Underweight infants are more vulnerable to lethal infections, especially in the first few months of life.

Naralis DeJesus, a 24-year-old Dorchester mother of two girls, understands the urgency.

Living in a shelter three years ago with her then-3-year-old daughter, DeJesus gave birth to a son, Deyon, who was three months premature and frail.

Determined to finish her college education while raising two children on her own, DeJesus bounced from a shelter to an unheated motel room and back to another shelter, where she shared a bed with her infant son because there were no cribs.

One morning, 6-month-old Deyon didn’t wake up. He died in his sleep of sudden infant death syndrome, a name given by specialists to unexplained deaths of children under the age of 1.

“I did get housing two weeks later, and the sad part is that my son never got to have a home,’’ DeJesus said at the news conference.


She has gone on to complete college with a criminal justice degree, has a home of her own, and is starting a new job.

“Sometimes I feel like if I did have a home and wasn’t all stressed, and there were changes in my life, I feel like that might have saved his life,’’ she said.

The new program “could really save not one life but two,’’ she added. “It could save the mother and it could save the child.’’

Laura Runnels, a senior program analyst with the National Association of County and City Health Officials, said the Boston program is unique.

“There are a lot of housing initiatives that are linked to some sort of social services, but this is the first time that we’ve heard of anything like this where the health department is so closely involved with the housing authority,’’ she said.

The city is devoting $40,000 to train staff for the pilot program, and using a $10,500 grant from the March of Dimes, officials said.

As part of the initiative, detailed by Mayor Thomas M. Menino, a task force of leading doctors, nurses, and other health care providers will identify ways to improve health care for women and infants.

“This new program will focus on the quality of care and how the health care they receive can reduce . . . stress,’’ Menino said.

Dr. Audra Robertson, an obstetrician at Brigham and Women’s Hospital and co-chair of the new task force, said she has had many patients who delivered low birth-weight babies and has seen first-hand the hurdles many have faced to get quality health care.


She said that women who have delivered underweight babies prematurely are often prescribed during subsequent pregnancies a medication, progesterone, that helps reduce the risk for delivering another baby early.

But low-income women often have trouble getting the medication, Robertson said, not because of health insurance problems but because of transportation hurdles - the medication is usually delivered as a once-weekly injection for 10 weeks.

“We need to find ways to streamline processes,’’ Robertson said, “so health care is effective.’’

Kay Lazar can be reached at klazar@globe.com. Follow her on Twitter @GlobeKayLazar.