County report: decade-long effort to reduce African American child deaths shows mixed results; locally run programs report specific gains

First 5 Sacramento and community partners presented findings Aug. 4 from the multi‑pronged initiative to reduce African American child deaths, highlighting program gains in service delivery and stabilization even as countywide infant mortality rates rose in the 2020–2022 period.

Why it matters: The initiative — a collaboration between First 5 Sacramento, the Black Child Legacy Campaign (backed by Sierra Health Foundation), county departments and community-based providers — aims to reduce preventable deaths for children 0–5 by combining direct services (crib distribution, safe‑sleep education, pregnancy peer support), concrete assistance and systems change. Commissioners were shown program-level outcome data and countywide trend data covering the COVID era, which staff and partners said complicates interpretation.

Program highlights presented to the commission included: - Black Mothers United (BMU): The pregnancy peer‑support program served pregnant people with weekly coaching, doula care and home‑based supports. During the fiscal year, 66 BMU infants were born and “for the fifth consecutive year, there were 0 newborn deaths as of program exit,” staff reported. Looking at births from 2020–2022, evaluators reported one infant death among 241 BMU births (a rate of 4.1 deaths per 1,000 births), which the evaluator said was lower than the countywide African American infant mortality rate of 12 per 1,000 in the same period and lower than the county total of 5.2 per 1,000. - SafeSleepBaby: The safe‑sleep education program trained more than 1,000 caregivers in the fiscal year and distributed more than 600 cribs (about one‑third to African American families). Follow‑up surveys showed increases in recommended practices; African American participants reached for follow‑up were significantly more likely to report always placing infants on their back for sleep after the workshop. - Concrete Needs program and community incubators (CILs): Community partners reported stabilizing 363 families during the year through emergency supports such as hotel stays, rental and mortgage assistance, transportation and groceries. First 5‑aligned partners said the Concrete Needs effort had delivered about $787,000 in direct supports to families in high‑need ZIP codes and that stabilization was coupled with case management to pursue longer‑term outcomes. - Family Resource Center strategies: Home visiting, group parenting education, crisis case management and light‑touch social supports were reported to increase protective factors, parenting knowledge and connections to immediate needs for participating families.

Countywide trends: Evaluators from Applied Survey Research cautioned that the most recent data (calendar years 2020–2022) fall squarely in the COVID era and noted the pandemic’s broad social and economic impacts. Key points shown to the commission included: - The African American infant mortality rate for 2020–2022 was 12 per 1,000 births, an 11% increase compared with the earlier benchmark period used by the Blue Ribbon Commission. The countywide rate for the same period was 5.2 per 1,000. - Deaths tied to perinatal causes rose (a reported 14% net increase), and sleep‑related infant deaths showed an anomalous spike in 2021 (seven deaths) before dropping back to three in 2022; evaluators said 2021 may reflect pandemic‑era disruptions in community outreach and services. - Child‑abuse‑and‑neglect homicides for children 0–5 continued to show long‑term reductions compared with the baseline established for the Blue Ribbon Commission, though evaluators noted the African American rate remains higher than other groups.

Voices from the field: Community providers and program participants spoke to commissioners about how local services operate in practice — from pregnancy coaching and doula support to emergency hotel stays, vehicle and housing assistance. A BMU pregnancy coach described pandemic‑era disruptions to in‑person support and said face‑to‑face engagement has resumed and is driving new referrals. A parent who received Concrete Needs supports recounted how the network’s wraparound case management helped a child injured in a domestic incident and assisted the family to stabilize housing and basic needs.

What commissioners heard and next steps: Commissioners and presenters emphasized two themes: (1) program‑level interventions show measurable benefits for participants, and (2) COVID‑era data complicate countywide trend interpretation and may mask or reverse earlier gains. Evaluators and partners told the commission they will continue implementation while refining measurement and community engagement. Staff noted a planned publication of updated strategic goals and said they expect further evaluation summaries and continued community co‑design in coming months.

Limitations and context: Presenters repeatedly said the community‑based programs reach only a portion of the population in need and that the pandemic made 2020–2022 an atypical period. Evaluators cautioned that the numbers shown are recent but subject to the three‑year reporting cadence the county uses for child death reviews and public health datasets.