Mayor Paul Soglin has proposed a plan to reopen the South Madison Health and Family Center – Harambee to help address the increasing African American infant mortality rate in Madison.
The resource center, known simply as Harambee, was influential in the drop of the African American infant mortality rate in the late ’90s and early 2000s. With current increasing rates of infant mortality, Soglin feels Harambee will provide a benefit to the community.
Harambee was established in 1995 to assist low-income families and families of color by focusing on women’s health, Soglin said. After Harambee was established, African American infant mortality dropped every year until the rate of African American infant mortality was lower than white infant mortality in Dane County in 2004.
Infant mortality among black people in Dane County started to fall after 1995, when Harambee opened, according to the Dane County Fetal Infant Mortality Review. These numbers continued to drop until they reached the lowest point in 2004. After this low period between 2004 to 2007, Harambee closed its doors in 2010. Once Harambee closed, numbers of African American infant mortality rose back to about the level before the program was established.
Courtesy of Public Health Madison & Dane County
The original purpose of Harambee was to link community members with other health and social services, Soglin said. In Swahili, Harambee means “pulling or working together.”
“The counseling and advice provided by Harambee may have been very instrumental in the health outcomes [of African American families],” Soglin said.
The severe drop in African American infant mortality was unlike anywhere else in the United States and had medical professionals examining Madison communities to find the answer to this success, Lee Dresang, a UW assistant professor and expert on infant mortality, said.
Dresang said from 2004-07, African American infant mortality decreased substantially, receiving national attention. One hypothesis is the availability of prenatal care, Dresang said.
Prenatal care is instrumental to a healthy pregnancy, and without services like Harambee it is hard for some to afford proper care, Dresang said.
Soglin said the decreased mortality rate was the product of a social health intervention. The people at Harambee were able to create a relationship with younger women who were having children. These relationships helped expecting mothers maintain a healthy pregnancy, which helps explain the dramatic decline of African American infant mortality.
These personal connections that helped young women do not show up on medical charts, Soglin said.
Harambee offered mothers resources to access adequate prenatal care that they might not receive otherwise, Dresang said. These resources were especially important to low-income families and families of color.
“Many studies have found that increases in accessibility and quality of medical care improve the rate of infant mortality,” Dresang said.
At time time of its 2010 closure, Soglin said the city administration viewed Harambee as not providing any services on its own, but only directing people to other resources. Harambee did create personal relationships that helped young women maintain a healthy pregnancy and provided needed support.
But once Harambee closed, African American infant mortality in Dane County began to rise back to the same levels as before the establishment of Harambee.
“The decline [in African American infant mortality] began within two years after the founding of Harambee and it ended within two years of the dismantling of Harambee,” Soglin said.
Dresang said the rise in infant mortality among black people between 2008 and now has been influenced by the national recession. Resources previously accessibled through Harambee were not as prevalent, especially for low-income families.
The recession was especially hard on neighborhoods of lower socioeconomic status — the same neighborhoods that used the services of Harambee the most, Dresang said.
Soglin said he hopes to reestablish Harambee with funds that still exist in the program’s accounts. Soglin said if the funds can reopen Harambee and get it going again, the program will receive budget support in later years.
Harambee will not use any of the current budget but it will need financial support when the existing funds run out. Soglin said putting the program in the budget for next year will prepare the city to fund this important service.
“Perhaps we ought to try to replicate that experience [of Harambee] and see what happens to infant mortality,” Soglin said.
