title: Growing a Best Babies Zone: Lessons Learned from the Pilot Phase of a Multi-Sector, Place-Based Initiative to Reduce Infant Mortality.
abstract: OBJECTIVE
  Infant mortality reduction in the U.S. has been addressed predominantly through clinical approaches. While these efforts have reduced the infant mortality rate overall, they have not reduced disparities between different racial/socioeconomic groups. To address the interrelated social, economic and environmental factors contributing to infant mortality, a place-based approach is needed to complement existing initiatives and clinical practices.
  
  
  METHODS
  Best Babies Zone (BBZ) is an early attempt to put life course theory into practice, taking a place-based approach to reducing infant mortality by aligning resources, building community leadership, and transforming educational opportunities, economic development, and community systems in concentrated neighborhoods. BBZ is currently in three neighborhoods: Price Hill (Cincinnati, OH), Hollygrove (New Orleans, LA), and Castlemont (Oakland, CA). Assessment In its first 4 years, each BBZ crafted resident-driven strategies for decreasing the root causes of toxic stress and poor birth outcomes. To address resident priorities, BBZ sites experimented with tools from other fields (like design thinking and health impact assessment), and emphasized existing MCH strategies like leadership development. Early challenges, including shifting from traditional MCH interventions and addressing health equity, point to areas of growth in implementing this approach in the maternal and child health field.
  
  
  CONCLUSIONS
  BBZ aims to elevate local voice and mobilize multiple sectors in order to address the social determinants of infant mortality, and other initiatives working to improve MCH outcomes can learn from the successes and challenges of the first 4 years of BBZ in order to bring life course theory into practice.
authors.affiliation: School of Public Health, University of California, Berkeley, 279 University Hall, Berkeley, CA, 94720-7360, USA. cpies@berkeley.edu.
authors.forename: Cheri
authors.initials: C
authors.lastname: Pies
authors.affiliation: School of Public Health, University of California, Berkeley, 215 University Hall, Berkeley, CA, 94720-7360, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Barr
authors.affiliation: School of Public Health, University of California, Berkeley, 270 University Hall, Berkeley, CA, 94720-7360, USA.
authors.forename: Carly
authors.initials: C
authors.lastname: Strouse
authors.affiliation: Division of General Academic Pediatrics, MGH Center for Child & Adolescent Health Research and Policy, MassGeneral Hospital for Children, Boston, MA, USA.|Department of Pediatrics, Harvard Medical School, 125 Nashua Street, Room 8402, Boston, MA, 02114, USA.
authors.forename: Milton
authors.initials: M
authors.lastname: Kotelchuck
mesh_terms: D002140:California; D002648:Child; D019058:Community Networks / Q000191:economics / Q000458:organization & administration*; D005260:Female; D062489:Health Impact Assessment; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008430:Maternal-Child Health Centers / Q000458:organization & administration*; D055820:New Orleans; D009820:Ohio; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology; D011634:Public Health / Q000379:methods; D064890:Social Determinants of Health; D012959:Socioeconomic Factors
keywords: Infant mortality; Life course theory; Place-based approach; Racial and socioeconomic disparities; Social determinants of health