MCMS Physician Winter 2017 - 10

mon t m e d s o c .c om

and pregnancy outcomes.xii Pre-conception/pre-pregnancy
interventions targeting behaviors such as tobacco, alcohol,
drug abuse, target behaviors, adequate folic acid consumption,
and diet before pregnancy have been successful in improving
birth outcomes.xiii

Montgomery County Infant Mortality
Stats
Overall, there appears to have been a decline in the
infant mortality rate, but racial disparities continue to exist.
Research has shown that these disparities continue to exist
and in some cases increase, even with advances in public
health and medicine. In 2013, the most recent comparable
data, the infant mortality rate for non-Hispanic black women
in Montgomery County was 17.4 per 1,000 live births, 4.1
times the rate for non-Hispanic white women (4.2) (Figure
1).
Figure 1. Infant Mortality Rates, by Race: Montgomery
County, Pennsylvania, United States, 2013

transcend all areas of government whether planning, law
enforcement, housing, or health.
County government is striving to be a true embodiment
of "One Health" and "Health in All Policies" approaches
in letter and in spirit, with participation and partnerships
across sectors. It is clear that the social, economic, and
broader environmental factors will need to work in tandem
with health care to attain the best returns on dollars spent in
Montgomery County on attaining a healthier society. Efforts
to expand and strengthen residents' opportunities and reduce
barriers to engage in healthy behaviors, and improve health
status and quality of life are guided by three key principles:
mapping and placed-based approaches targeting high need
areas; Health in All Policies; and multi-sectoral integrated
programs and service delivery.
A number of initiatives are currently ongoing that focus
on neighborhoods with social, economic, and environmental
barriers that have led to or are associated with poor health
outcomes including high IMR, health disparities, and quality
of life overall.
Specifically, for reducing high IMR and associated
disparities, county officials are crafting a two-pronged
strategy:
A. Increase the accessibility and availability
of well-women health and prenatal care including
preconception and inter-conception activities
B. Address social determinants of health especially
building resilience to the negative social determinants
through social and behavioral support interventions

Sources: Centers for Disease Control, Pennsylvania Department of Health, 2016

In line with national trends, over 2/3 of IMR is in
neonatal period. However, over 65 percent of IMR in the
county was attributable to prematurity (80 percent) and
congenital anomalies (20 percent).

Montgomery County (MC) Strategy
to Reduce Infant Mortality and Related
Disparities
Persisting health and socio-economic disparities and
inequities in pockets of high poverty, unemployment, and
subsequent poor health indicators are of acute concern to
Montgomery County leadership. MC recognizes that for
addressing full spectrum of health priorities-from pockets of
IMR to HIV/AIDS to cancer to prevention and emergency
preparedness for Zika virus disease-interventions must
address clinical, public health, and social determinants in
a seamless continuum for optimal efficiency, effectiveness
but more importantly sustainability. These inequities and
disparities garner special attention and rank high on a list
of holistic and coordinated remedial interventions that

This two-pronged strategy has materialized the following
initiatives and interventions thus far:
1. Establishment of a Department of Health &
Human Services (HHS): Effective mid-2016, county
government brought together departments of public
health, aging, housing, veterans affairs, behavioral
health, mental health, and children and youth services
under one larger department of health and human
services (HHS) to ensure optimal coordination and
integration of various services that directly or indirectly
affect physical, mental, and social health attainment by
the county residents. HHS is led by a senior-level and
experienced director.
2. Community Connections: This One Vision,
One Service, One Door initiative of Montgomery
County has been operating for three years now in
four county offices and five part-time expansion sites
located throughout the County. It offers one-stop
service centers and provides a "front door" to human
services in the county providing a jump start to address
beneficiaries' identified housing and nutrition issues.
3. Montgomery County Collaborative Network:
Montgomery County has demonstrated success with
interdisciplinary collaborations between clinical

M C M S P H Y S I C I A N 10 W I N T E R 2 0 1 7
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Table of Contents for the Digital Edition of MCMS Physician Winter 2017
