TUSCALOOSA, Ala. – University of Alabama School of Social Work researchers will soon expand a statewide drug and mental health screening program to address infant mortality in Alabama.
The School of Social Work’s Vital team, which oversees an $8 million AL-SBIRT contract, recently received $750,000 from the state to begin, “Reducing Infant Mortality Through Improved Wellness,” an initiative to reduce substance abuse, depression and domestic abuse in women that are pregnant, attempting to conceive or have recently conceived.
The program will target three counties in Alabama – Montgomery, Macon and Russell, which, combined, had 650 preterm births and 45 infant deaths in 2016, according to the Alabama Department of Public Health. From 2014-16, these three counties had an infant mortality rate of 10.1 per 1,000 live births, significantly higher than the state average of 8.7 during that span.
This initiative is part of a state-appropriated $1 million plan to reduce IMR rates by 20 percent in these three counties by 2023.
“The IMR is an essential measure of the health of women of child-bearing age within a state, and Alabama, historically, has had a high IMR in comparison to the rest of the United States,” said Dr. David L. Albright, professor, Hill Crest Endowed Chair in Mental Health Research, and principal investigator for the project. “Health outcomes are molded by the environment in which people are born, live, work, play and age, and not simply by health behaviors of the individual. These factors, which contribute to health outcomes, are formed by the historical, social, political and economic forces in the individual’s environment.”
Some of the leading causes of infant mortality in Alabama include birth defects, preterm births and sleep-related deaths, like accidental suffocation and Sudden Infant Death Syndrome, or SIDS. There are multiple causes of pre-term births and many known risk factors of birth defects, including genetic, environmental, socioeconomic, demographic and maternal health, among others, according to the Alabama Department of Public Health.
The project’s approach will mirror AL-SBIRT’s model of integrating behavioral health into primary care settings. AL-SBIRT, funded by the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services, incorporates alcohol and drug screenings, brief interventions and referral to treatment into these settings.
The Vital team will utilize this public health approach in OB-GYN practices in the three counties and will provide referrals to women experiencing substance abuse, domestic violence and/or depression.
The Vital team will spend the next six months cultivating relationships with care providers and building out the training program. Success of the project will hinge greatly on buy-in from OB-GYNs who “champion” the AL-SBIRT screening tools as part of a “continuum of care,” said Shanna McIntosh, Vital project coordinator.
“As of right now, with our reimbursement structure in the state and how health is viewed as more privatized, it’s important that we’re looking at holistic ways to provide med care, taking into consideration behavioral and mental health as it relates to depression and substance use,” McIntosh said. “This will have a long-term impact on the way our patients in these areas are receiving care.”