OFFICE OF THE CITY COUNCIL
117 WEST DUVAL STREET, SUITE 425
4TH FLOOR, CITY HALL
JACKSONVILLE, FLORIDA 32202
Public Health and Safety Special Committee Meeting Minutes
April 18, 2017
Immediately after the Regular Committee Meeting
Topic: Infant Mortality
Location: City Council Chamber, 1st floor, City Hall – St. James Building, 117 West Duval Street
Attendance: Council Members: Sam Newby (Chair), Anna Lopez Brosche, Katrina Brown, Aaron Bowman, Bill Gulliford
Also: Paige Johnston – Office of General Counsel; Kim Taylor – Council Auditor’s Office; Jordan Elsbury – Mayor’s Office; Colleen Hampsey– Council Research; Philip Zamarron – Legislative Services Division
Meeting Convened: 9:15 a.m.
Chairman Newby called the meeting to order. The first presentation was by Dr. Kelli Wells, Director of the Department of Health in Duval County. Dr. Wells provided a Zika virus update and reported that overall the number of localized cases has decreased, but the decrease should not lead to less vigilance. Dr. Wells emphasized the importance of prevention before infection. Dr. Wells then reported on the current state of infant mortality in Duval County, which has decreased in frequency but exhibits a large racial disparity between black and white mothers.
Dr. Kristina Wilson of the Department of Health (DOH) spoke further about infant mortality, health disparities and health inequities. Dr. Wilson described the social determinants of health, which include living conditions, education, housing, employment, food and socioeconomic status. According to their Community Health Improvement Plan, the DOH goal is to reduce the black-white infant mortality gap by 26 percent. In Duval County, infant mortality rates vary depending on zip code, with 32209, 32208 and 32219 having the highest rates. According to Dr. Wilson, the biggest contributors to infant mortality are low birth weight, prematurity and sudden unexpected infant death. To combat the infant mortality issue and lessen the racial disparities in outcomes, Dr. Wilson advocated for a public health approach, to include data collection, identifying risk factors, developing effective practices through research, intervention and the dissemination of results.
The next presenters were Faye Johnson, Director of Northeast Florida Healthy Start Coalition (NFHSC), and Dr. Jeffry Will, Director of the Center for Community Initiatives at the University of North Florida (UNF). Created in 1991 through state Healthy Start legislation, Northeast Florida Healthy Start Coalition is one of 32 community coalitions throughout Florida. Northeast Florida has consistently had rates of infant mortality higher than the rest of the state. Duval County leads the region in infant mortality and significant disparities persist, the black infant mortality rate is more than twice the rate of white infant deaths. Ms. Johnson described infant mortality race disparities in Jacksonville and outlined several of the programs her organization oversees which are attempting to address the problem. NFHSC has programs specific to pregnant mothers battling addiction (Azalea project), nurse family partnership (home visits before and after birth), fatherhood (case management and education), and the Magnolia project (which supports women before, during and after pregnancy).
Dr. Jeff Will, Director of the Center for Community Initiatives (CCI) and professor of sociology at UNF, spoke about the Magnolia project. Dr. Will has been the evaluator since the inception of the program in 1999. Through process and outcome evaluation, CCI has found that the health of the mother before conception has the greatest impact on infant mortality and that infant mortality risk factors include previous poor birth outcomes, STDs, and having no source of health care. The Magnolia project was created in Jacksonville because Duval was one of three counties in 1995-97 with an infant mortality rate significantly higher than the state average. Using these strategies: community outreach, intensive case management, enhanced clinical care and education in zip codes 32208 and 32209, the Magnolia project has seen improvements for its participants (of 193 mothers, 5.2 percent had low birth weight babies with 0 infant deaths between 2009 and 2014). Dr. Will explained how evaluation is essential to understanding the effectiveness of a program, to measure outcomes and how evaluation methods were incorporated into the design and implementation of the Magnolia project. The Magnolia project is funded through federal grants and collaborates with partners like the Department of Health and other local nonprofit organizations.
Meeting Adjourned: 10:08 a.m.
Minutes: Colleen Hampsey, Council Research
5.2.17 Posted 4:00 p.m.
The written minutes for this meeting are an overview of the discussion. For verbatim comments, the video version is accessible through the PHS webpage or it may be retrieved from the Office of Legislative Services.