In response to The Roanoke Times article of June 26 regarding a higher maternal death rate among women of color in Virginia, it is important to know this health disparity, when an adverse health outcome is disproportionately higher for one group within a community than for the population as a whole, is preventable. And, maternal deaths are not only dramatic statistics but they are extreme symptoms of an adverse community environment (ACE) such as poverty, discrimination, violence, poor housing quality and affordability and lack of opportunity, economic mobility and social capital.

When a family lives in an adverse environment, children grow up with adverse childhood experiences (ACE) including maternal depression, divorce, mental illness, substance abuse, incarceration, domestic abuse, homelessness, emotional and physical neglect and emotional and sexual abuse.

This pair of ACES is like a tree planted in bad soil where the leaves wither and die before it can develop into its full potential.

Fortunately, in the Roanoke and New River Valleys we do have at least three effective systems in place to mitigate the pair of ACES that do exist.

It has long been established by educators, physicians and public health experts that home visiting by trained staff is the most effective means to prevent some ACES and mitigate the effects of others. In Roanoke and New River, our public health nurses are doing Babycare, an effective home visiting intervention for pregnant moms and babies in families that struggle with ACES.

Roanoke started CHIP, Child Health Investment Partnership, 31 years ago to address ACEs. CHIP nurses and family case managers not only do Babycare but also continue providing home based services until school entry. The outcomes have been noted nationwide and CHIP children enter school healthy and ready to learn as parents find educational and employment opportunities, life skills and parenting skills.

Additionally, through the leadership of Dr. Kim Simcox, pregnant moms can receive addiction services and prenatal care jointly at the New River and Roanoke Carilion facilities.

It’s incumbent on every citizen to assure pregnant moms and babies access to the best we have to offer.



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