In recognition of National Public Health Week, Research!America is spotlighting public health professionals who work at the national and local levels to address the most pressing issues that affect communities nationwide.
Below, Adelaide Appiah, MPH, Program Director for Creating Healthier Communities (CHC), discusses CHC’s efforts to reduce the burden of Black maternal mortality, shares what still needs to be done to improve maternal care of Black, Indigenous, and People of Color (BIPOC) communities, and gives a brief look into CHC’s Black Birthing Initiative.
What factors inform your work?
Things like report data, particularly from the CDC, that is specific to maternal health and disaggregated by race and communities influences my work. But community voices influence my work the most. I also follow community leaders like Ky Lindberg at Healthy Mothers Healthy Babies Coalition of Georgia, Jemea Dorsey at the Center for Black Women’s Wellness in Atlanta, and Jazmin Long at Birthing Beautiful Communities in Cleveland. There are pioneers and changemakers in local communities that are taking care of Black people in their communities and have been doing that for a long time; those are the organizations I follow. Those are the organizations whose work needs to be in the Huffington Post, in the New York Times, and in CDC reports. The changes that are happening in the local communities are not reflected a lot of times in those bigger national reports. And so, what informs my work is literally plowing through and looking for local news around maternal health and Black health outcomes.
In what ways do you collaborate/engage with partners, committees, workgroups, or other agencies?
As a fellow of the Culture of Health Leaders Institute for Racial Healing, a leadership program supported by the Robert Wood Johnson Foundation, I center the Truth, Racial Healing and Transformation™ Framework. Within this framework work, I focus on racial healing and relationship building, which means I focus on ways for all of us to heal from the wounds of the past, to build mutually respectful relationships across racial and ethnic lines that honor and value each person’s humanity, and build trusting intergenerational and diverse community relationships that better reflect our common humanity. It is with this lens that I lead efforts at CHC that support community-based organizations with program implementation efforts to reduce preterm birth and increase access to breast and cervical cancer screenings as well as health vaccinations.
Community organizations are our priority groups. We also work with national organizations that I call our organizational sisters, including the Association of Maternal and Child Health Programs and the National Association of County and City Health Officials (NACCHO), who are also moving the needle in these spaces. I also work with many other local public health workgroups. Much of my work is informed by the Robert Wood Johnson Culture of Health Fellowship that I’m part of.
What improvements have you seen in the maternal care of BIPOC birthing people? What still needs to be done?
There’s this misconception that when you talk about health equity, you’re only talking about Black health when that’s not true. Health equity encompasses the health and wellness needs of every individual person. Since the murder of George Floyd, people have been galvanized to figure out what health equity means. There’s been a lot of talk around equity, and it seems that people are becoming more receptive to what Black leaders have been saying about their communities’ health for a long time. More people are open to joining the conversation and listening. As for improvements, there needs to be more action that comes from the listening. Also, health providers and policymakers need to be held accountable because they have the opportunity to really make a change. Those changes can look like trainings and implementing hospital policies that focus on patient-centered care and evidence-based midwifery models of care.
The midwifery model of care and the importance of a doula are things that Black people have known and have rights to — they’re a part of our culture. With the introduction of medicalized birth, we started to rush the labor process and forgo listening. And today in the U.S., most births are done in a hospital setting. I believe that if a midwifery model of care was institutionalized, and all hospital systems and providers learned how to co-care with midwives and doulas, everyone would have better birth outcomes, not just Black women.
One of the daily themes for National Public Health Week is reproductive and sexual health. How is CHC incorporating health equity into their Black Birthing Initiative?
The Black Birthing Initiative aims to reduce preterm birth outcomes in our focus areas. The initiative’s primary goals are to reduce preterm birth outcomes by looking at the association between stress and social determinants of health factors and provide every pregnant person that comes across our program with a birth advocate. A birth advocate can be a doula, a community health worker, or somebody advocating for them over the course of their birth. We spent a year in our cities doing research on what it would mean to tackle reducing preterm births among Black women and birthing people. From that, we developed a study design and implementation guide. Our current grantees are funded to implement the guide to prove if what we think is possible is actually possible.
We recognize that Cleveland is not the same as Detroit and Detroit is not the same as Atlanta. So, every implementation guide is amendable to that community context because no community is monolithic. That’s the way in which we’re centering health equities. Our hope is that we do what works for their community within the implementation guide that we’ve developed to reduce preterm birth outcomes among Black women.
Bio: Adelaide Appiah has a bachelor’s degree in public health and sociology from The Ohio State University, and a master’s degree in public health and maternal and child health from George Washington University. Her public health journey began as an intern with the Henry Ford Health System in Detroit during her undergraduate years. She has spent 10 years in the public health field and has focused on topics such as sexual and reproductive health, HIV, maternal and child health, and racial inequities. She currently works as the Program Director at Creating Healthier Community, which is a nonprofit focusing on community health and health inequities.