Changing the Narrative to Shift Power:

Detailing the impact that systems have on Black maternal & infant health in St. Louis

In St. Louis, Black moms and babies are dying at a higher rate than any other race.  This pattern isn’t caused by individual choices or behaviors – it’s due to the long history of racism in our region.

It is estimated that individual medical care only makes up about 10-20% of a person’s health outcomes.  The other 80-90% is due to  social determinants of health , or the political, socioeconomic, environmental, and cultural factors that impact a person’s health.  Missouri’s  history with slavery  and St. Louis’ history of  redlining ,  racial covenants in home deeds ,  environmental racism , and  other racial inequities  are some of the root causes of the health disparities that our region faces, both past and present.

Experiencing Racial Bias in Healthcare

Traditionally, health and social service providers and policymakers have focused on individual solutions to systemic problems. In addition, white dominant culture has built power structures and socialized members of our society to give preference to certain groups and oppress others, which has perpetuated racial disparities in maternal and infant health.

We need a systems change approach to a systemic issue.

What do we mean by 'systems change'?

Systems change requires "adjustments or transformations in the policies, practices, power dynamics, social norms, or mindsets that underlie the societal issue at stake." (Source:  New allies: How governments can unlock the potential of social entrepreneurs for the common good )

In other words,

"We're thinking about systems change not as an issue or person that needs to be fixed... it's the set of conditions that surround the individual. We need to work on shifting the conditions that hold the problem in place" -John Kania

How Racial Inequities Impact Infant Mortality in St. Louis


Black Maternal & Infant Mortality by the Numbers

Counts of Black infant mortality in the St. Louis Region


Seeking Solutions: How do we close this disparity gap so that Black moms and babies FLOURISH?

 Generate Health  is a multi-racial coalition of community, providers, policymakers, and other stakeholders that's focused on eliminating racial disparities in maternal and infant health. Through our initiative,  FLOURISH , we center Black women, birthing people, and their families in making decisions and identifying solutions to this problem.


When Black people with lived experience hold leadership positions and decision-making power, Black moms, babies, and entire communities see positive outcomes.  Those who experience the most harm have the most potent medicine and hold the solutions that benefit everyone.


Strategy 1: Investing in neighborhoods and communities most impacted by maternal and infant mortality is critical to reducing deaths. From 2019-2022, Generate Health STL has been working to center those impacted, by providing funding to organizations through the FLOURISH initative to address the persistent disparities. FLOURISH facilitated a community-led process through which Missouri Foundation for Health distributed $2.92 million in grants to 105 organizations.  86% of these organizations are Black-led and all are grounded in the communities they serve.

Da Hood Talks Podcast

This FLOURISH grant funded the “DaHood Talks” Podcast, which started to air in 2021. This community podcast helps improve community engagement, educate and provide resources that empower and promote a healthy wellbeing for Black moms and their families, and supports and encourages advocacy for Black moms and their families.

Narcissistic Abuse Recovery Center

This FLOURISH grant funded the “Healthy Moms, Healthy Babies” project at the Narcissistic Abuse Recovery Center. The purpose of this grant was to provide awareness, education, and prevention of infant mortality in St. Louis through a virtual one-day wellness retreat, which provided support services, supplies, and resources to new and pregnant moms. This project occurred from February 2021 through October 2021.

Faith for Justice

This FLOURISH grant funded the “People Powered Health Justice” program led by Faith for Justice. This program connected Black mothers and parenting households to holistic health services and public justice initiatives while organizing these impacted communities to advocate for policies that strengthen their own families and neighborhoods. This project occurred from July 2021 through December 2021.

I Am: Breastfeeding

This FLOURISH grant funded I Am: Breastfeeding to create a community of support that provides equitable access to breastfeeding, perinatal and wellness resources to increase maternal vitality and decrease perinatal depression rates among Black mothers. This project occurred during May 2020-April 2021.

A Red Circle

A Red Circle hosted Healthy Mom and Baby Dinners to provide postpartum parents with information, confidence and social support to make healthy food choices. Healthy meal kits were delivered to families with accompanying virtual programming. A Red Circle also hosted Parent Cafes to create safe spaces for families to have authentic conversations to gain emotional, social and leadership skills and reduce their stress. These projects were held between September 2020 and February 2022.

Da Hood Talks Podcast

This FLOURISH grant funded the  “DaHood Talks” Podcast , which started to air in 2021. This community podcast helps improve community engagement, educate and provide resources that empower and promote a healthy wellbeing for Black moms and their families, and supports and encourages advocacy for Black moms and their families.

Narcissistic Abuse Recovery Center

This FLOURISH grant funded the “Healthy Moms, Healthy Babies” project at the  Narcissistic Abuse Recovery Center . The purpose of this grant was to provide awareness, education, and prevention of infant mortality in St. Louis through a virtual one-day wellness retreat, which provided support services, supplies, and resources to new and pregnant moms. This project occurred from February 2021 through October 2021.

Faith for Justice

This FLOURISH grant funded the “People Powered Health Justice” program led by  Faith for Justice . This program connected Black mothers and parenting households to holistic health services and public justice initiatives while organizing these impacted communities to advocate for policies that strengthen their own families and neighborhoods. This project occurred from July 2021 through December 2021.

I Am: Breastfeeding

This FLOURISH grant funded  I Am: Breastfeeding  to create a community of support that provides equitable access to breastfeeding, perinatal and wellness resources to increase maternal vitality and decrease perinatal depression rates among Black mothers. This project occurred during May 2020-April 2021.

A Red Circle

 A Red Circle  hosted Healthy Mom and Baby Dinners to provide postpartum parents with information, confidence and social support to make healthy food choices. Healthy meal kits were delivered to families with accompanying virtual programming. A Red Circle also hosted Parent Cafes to create safe spaces for families to have authentic conversations to gain emotional, social and leadership skills and reduce their stress. These projects were held between September 2020 and February 2022.

Strategy 2: We listen to, support, and center those with lived experience. These individuals and their families are closest to the issue at hand and are best positioned to provide effective solutions. When Black women and birthing people are in positions of influence, systems change.

Congresswoman Cori Bush, Mayor Tishaura Jones, Dr. Amber Johnson, and Shavanna Spratt are examples of people with lived experience doing transformative work in the St. Louis region.


Congresswoman Cori Bush

In January 2021, Congresswoman Cori Bush was sworn in as the first Black woman to be elected to represent Missouri in the United States House of Representatives. A few months later, she gave testimony about nearly losing both of her children because her healthcare team did not believe her pain.

St. Louis Congresswoman Cori Bush describes nearly losing her two babies

Since being in office, Congresswoman Bush has used her lived experience as a mom, nurse, pastor, and community activist to prioritize legislation and federal funding that will have the largest impact on parts of the St. Louis region that have experienced the greatest amount of disinvestment. She has championed legislation like the  Black Maternal Health Momnibus Act of 2021  and has directed hundreds of millions of dollars of federal investment to the St. Louis region.


Mayor Tishaura Jones

In October 2021, St. Louis Mayor Tishaura Jones shared her experience of having to save her vacation and sick leave to be able to spend time with her son after giving birth, since she did not receive paid leave through her workplace. In June 2022, a policy was passed by the Mayor Jones' office and the Board of Alderman to provide six weeks of paid family and medical leave for City of St. Louis employees.

Tishaura O. Jones on Twitter: "I saved up my vacation and sick leave to "try" and have at least 6 weeks at home after Aden was born. It's easy for the wealthy and privileged to say we don't need paid leave when they don't live check to check. https://t.co/l1662izLhG / Twitter"


Dr. Amber Johnson

Dr. Amber Johnson

Dr. Amber Johnson is a Professor of Communications and Associate Provost at Saint Louis University. They are a co-founder of the Institute for Healing Justice and Equity and the creator of The Justice Fleet, a mobile social justice museum that fosters healing through art, dialogue, and play. Their experience as a Black, non-binary birthing person has influenced the work that they do to advance equity and opportunities for healing in St. Louis.

“As a non-binary person who was pregnant, I was misgendered all the time. It pushed me down a path to study ways in which transmasculine folks don’t receive adequate healthcare, because people don’t see them. If a transmasculine person shows up with a uterus, they might be having pain in the stomach. But if the doctor doesn’t tag them as a person with a potential uterus, they might miss all types of diagnoses and treatments."


Shavanna Spratt

Shavanna Spratt

Shavanna Spratt is a resident of Ferguson and mom of two young children. She is a dynamic grassroots community advocate appointed to the Ferguson Human Rights Commission, a certified Doula, and member of FLOURISH’s first Community Leaders Cabinet.

In 2020, after recognizing a need for new outlets for community conversations, Shavanna launched a podcast, Da Hood Talks, to provide space for folks to talk about pressing issues. Some topics discussed on her podcast have included Black birth experiences, Black women strengthening their relationships with one another, and Black sisterhood supporting entire communities.


These stories demonstrate that when Black women and birthing people hold positions of influence, systems change and more opportunities become available in our community so that all families can thrive.


Join us in transforming systems to support Black maternal and infant health:

Data

MOPHIMS

What do we mean by 'systems change'?

Counts of Black infant mortality in the St. Louis Region

Dr. Amber Johnson

Shavanna Spratt