With Infant Death Rates at Grim High, Milwaukee Health Department Provides Help for African American Fathers

Trae Tyler (left) and Direct Assistance for Dads mentor Troney Small change 1-year-old Romel Tyler’s shoes outside Discovery World in July. Small’s program is working to fight the city’s infant mortality crisis by supporting African-American men. Alyssa Pointer
Trae Tyler (left) and Direct Assistance for Dads mentor Troney Small change 1-year-old Romel Tyler’s shoes outside Discovery World in July. Small’s program is working to fight the city’s infant mortality crisis by supporting African-American men.
Alyssa Pointer

Trae Tyler changed when he saw the ultrasound. Two tiny hands tucked behind a tiny head, a tiny foot crossed over a tiny knee. “That’s how I sleep!” Tyler said. “That’s my son!”

In that moment, Tyler took a huge step on the journey of fatherhood. Twenty-three years old, African-American, unmarried and living in one of Milwaukee’s poorest neighborhoods, he faced more challenges than most soon-to-be parents.

But he vowed to see it through.

On a sunny afternoon nearly two years later, Tyler squats down under a kapok tree at the Mitchell Park Domes. He scoops up his son, Romel Tyler, a healthy 20-month-old with pudgy cheeks and a toothy grin.

A small entourage watches nearby. On the left is Romel’s mother, Camry Simon. After suffering two miscarriages and fainting six times while pregnant with Romel, Simon, 24, still can’t believe she has a son.

She credits Erin Cronn, who’s standing on the right. Cronn is a nurse from the Milwaukee Health Department who visited Simon nearly every week during her pregnancy and twice a month after Romel was born. Today’s outing to the Domes is one of her last visits.

But it’s one of the first visits for Troney Small, the final member of the group. Small is a trained “fatherhood involvement specialist” who’s working with Tyler as part of a new Health Department program called the Direct Assistance for Dads project. It’s one of four pilot programs aimed at curbing the city’s infant mortality crisis by supporting African-American men.

In Milwaukee, babies die during their first year of life at rates associated with the Third World. Last year, 117 babies died in the city. Black babies in the city are nearly three times more likely to die than white babies. The three-year rolling average for black infant deaths climbed for the fourth year in a row, from 14.6 deaths for every 1,000 live births in 2010-’12 to 15.6 in 2011-’13. That’s worse than Libya and Cuba and the Ukraine.

The new numbers were discouraging for public health experts, who consider the infant mortality rate to be an essential indicator of a community’s well-being.

“It’s the canary in the coal mine,” says Geoffrey Swain, chief medical officer for the Milwaukee Health Department and a professor at the University of Wisconsin School of Medicine and Public Health.

In Milwaukee, infant deaths are concentrated in a handful of ZIP codes where poverty, unemployment and crime are high. In the ZIP code where Simon and Tyler lived while Simon was pregnant, 53212, the infant mortality rate among minorities for 2009-’11 was 18.5 deaths per 1,000 births, meaning nearly two of every hundred babies died before their first birthday.

Previous efforts to rein in Milwaukee’s infant mortality rate have focused on services for mothers: increasing access to prenatal care, treating underlying medical conditions such as diabetes, and reducing behaviors such as smoking and unsafe sleeping arrangements.

But four new programs target a less conventional group: African-American men.

Since 2009, the Wisconsin Partnership Program at the UW medical school has invested $10 million in the Lifecourse Initiative for Healthy Families. The targets of the money: Milwaukee, Racine, Kenosha and Beloit, which account for roughly 90% of African-American births in the state.

In 2013, after years of planning, each community launched a handful of programs to address infant mortality, each with an academic partner to evaluate its effects. Of the 12 programs now funded in Milwaukee, the four father-focused programs are receiving $1.25 million, more than half the total grant money coming to the city. The rationale behind that commitment is a growing body of research that identifies chronic stress as a primary factor in preterm birth, which is the leading cause of infant mortality. And that high degree of stress is associated with a web of biological and environmental factors, including violence, poverty, discrimination — and father involvement.

“Until now, we’ve been sadly and inappropriately dismissive of the role of the father in birth outcomes,” said Nicole Angresano, vice president of community impact for United Way of Greater Milwaukee. The agency is responsible for implementing the Milwaukee Lifecourse programs.

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SOURCE: Milwaukee Wisconsin Journal Sentinel
Sarah Maslin

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