Milwaukee Will Try Community Paramedics to Lower High Infant-Mortality Rate

In Milwaukee, more than 10 babies out of every 1,000 live births will die before their first birthday. That compares poorly to a national average of 6 deaths per 1,000.

"A major contributor to infant mortality is racial and ethnic health disparities,” says Jennifer Doering, PhD, RN, an associate professor in the University of Wisconsin-Milwaukee’s College of Nursing. “Three African-American babies die for every one Caucasian baby who dies, and this hasn’t changed in 30 years despite efforts to improve care provided to women and infants by the healthcare system, public health and through health policy.

“Stated another way,” Doering adds, “although we are the richest country in the world by GDP (gross domestic product), our African-American infant mortality rate in Milwaukee is worse than 77 countries around the world, including Cuba, Libya and Ukraine.”

In a bid to reduce Milwaukee’s infant mortality rate, the UWM College of Nursing and the Medical College of Wisconsin have begun training regional paramedics in a community-centered healthcare program. This training is based on a nationally used mobile integrated healthcare program (MIHP) aimed at reducing preventable visits by the chronically ill to emergency rooms.

In addition to the regular curriculum, the Wisconsin MIHP has been bolstered with infant healthcare information. This can be used by Milwaukee and state community paramedics (regular EMS staff who make “house calls” to chronically ill patients) to identify potential risks to infants in the home, and help parents mitigate and reduce those risks.

“Adapting the curriculum to the needs of our city and state was key,” says Doering, who is involved in the Wisconsin MIHP. This is because “infant mortality and the associated health disparities are not just a Milwaukee concern: We see similar health disparities and struggles in families across the whole state of Wisconsin.”

This is where the expanded MIHP training comes into play. “We believe that community paramedics who are providing care to some of the most vulnerable citizens of this state should be aware of the issue and what role they can play in helping to solve this challenge,” Doering says.

The fact that these community paramedics monitor and treat chronically ill patients in their homes is another reason why training community paramedics in infant health enhancement makes good sense. As trained medical professionals who are already on site, these community paramedics can spot other problems before they become serious.

“When a community paramedic is seeing Judy for an exacerbation of her congestive heart failure (CHF), he or she can look around and see that there is a baby lying on the couch and assess whether the baby has a safe place to sleep and provide resources and education to save that baby from accidental suffocation,” says Doering. “We also see great potential for future community paramedics to be able to administer pregnancy tests to women who may not be connected to the healthcare system for prenatal care. Sometimes confirmation of pregnancy and support to identify a clinic to receive care from is the encouragement they need to be connected to prenatal care so their own chronic health conditions can be better managed to prevent a stillbirth.”

It is too early to say that this community paramedics training program is reducing infant mortality in Milwaukee. “At this time one class of community paramedics has gone through the course, and we have just started the second group,” Doering says. “My understanding is that the program is still in pilot form and determining logistics, administration and funding.”

Still, the effort seems a step in the right direction.

“We are laying a foundation with training with the intent that ‘if we build it, they will come’,” she says. “I believe there will be more opportunities for engagement with the perinatal and infant populations as time goes on and the program in Milwaukee is more established.”

James Careless is a freelance writer with extensive experience covering computer technologies.