by Joel Addington
Contributing Writer
They have gathered each week for the last month to hear about Duval County owning the highest infant mortality rate in the state. They’ve talked about why so many infants die within their first year and which mothers are at risk of losing their babies.
And at the end of Thursday’s meeting at Mt. Zion AME Church, Joy Burgess asked the roughly 50-member study committee with Jacksonville Community Council Inc. (JCCI), “What are the unanswered questions?”
“We’ve had a lot of discussion about the health aspect (of infant mortality),” said Helen Jackson, another member of JCCI’s infant mortality study committee. “Environmental, behavioral and socioeconomic factors – we need to address those as well.”
That continuous self examination during JCCI’s study process ensures the committee looks at a problem from all sides before building consensus on what the community, as a whole, can do to help.
And with meetings scheduled through April, the committee will have plenty of time to gain insight into each and every aspect of this problem.
While infant mortality rates – calculated by dividing the number of infant deaths by the number of live births – have continued to decline in Florida since the 1970s, Duval County’s rate has always remained higher than the statewide number.
According the Florida Department of Health, the state’s average annual infant mortality rate from 2004-06 was 7.2, while Duval County’s average for the same period was 10.6.
Some of the committee members know this all too well.
Sally Myrick, executive director of United Way’s Healthy Mothers, Healthy Babies program, said, “It’s been a red flag here.”
The process
Although the infant mortality study is Myrick’s first, she said each step in JCCI’s study process is geared toward finding workable solutions to the challenges facing Jacksonville.
“They start by reaching out to community members with expertise and bring them together with the most current information for discussion and consideration,” she said. “This is a targeted group process to raise awareness among the community on a troubling issue.”
Although the study committees are the work horses of JCCI, much planning takes place prior to their first meeting, explained JCCI Executive Director Charles “Skip” Cramer.
“We always want new people to take part in our process,” he said.
That means advertising in print and radio to let the public know a new study is getting underway. With only two studies performed each year, JCCI aims for quality, not quantity.
“We look for topics that meet specific criteria,” said Cramer. “Is it manageable to fit with our time frame? Does it fit with the model of citizen-based community study rather than a scientific or academic study?
“Our purpose is to find citizen solutions to community issues. It’s a different approach, but with more than 70 studies under our belt, we’re pretty confident with it.”
The topics must also be of interest to a broad cross section of the community.
“We would not do a study on something that impacts a small area of Jacksonville or a small special interest group of folks,” said Cramer.
In April, study topics are narrowed by a 19-member committee down to a list of six possible studies for the year. They are debated and eventually whittled down to two.
“We’ve had folks dress up in costumes to sell their topics,” said Cramer, adding he brought in international food to push for a study on diversity. “It’s a fun process, but it’s serious work.”
Once topics are chosen the study committee takes over, performing the fact-finding part of the study. Experts from the community are brought in to educate the committee on the particular issue.
Representatives from Planned Parenthood and River Region Human Services presented at Thursday’s meeting. A week before, the infant mortality study group heard from a pediatrician and obstetrician.
“We need to have committee members develop a shared knowledge of the topics,” said Cramer, “which means consistent attendance.”
By March of next year, the group will be formalizing recommendations for a JCCI study report on infant mortality in Duval County.
“Some may come in saying, ‘I have the answer,’” said Cramer. “But once they go through the shared learning experience, it opens up their eyes to new solutions.”
The final report, however, has to be the product of consensus.
“Everyone on the committee has to be able to live with the recommendations. And that’s a challenge,” said Cramer.
Myrick, the first-time committee member, realizes the challenge as well.
“We’ll be able to reach a consensus on the causes and impacts (of infant mortality),” she said. “But prioritizing solutions is when the impassioned discussion will probably ensue.”
The impact
For JCCI, it’s important the studies don’t simply sit on a shelf.
After study reports are released to the public, a campaign to implement the recommendations commences.
“We immediately move into the advocacy stage,” said Cramer, who leads a JCCI staff of 12 employees.
He said the impact and value of JCCI’s studies vary depending on whom you ask, and Cramer specifically noted the study on restructuring the civil service system in 1979.
“The late Max Morris chaired that study and changed elected civil service by pushing for unitary primary elections and term limits,” he said. “The study recommended a complete overhaul.
“Another huge step was a study on coordination of human services,” added Cramer. “For 25 years it has helped coordinate health and human services to eliminate duplication of services and help with efficiency. It’s been a model that other communities have emulated.”
David Bailey, a retired pediatrician taking part in the infant mortality study, said he clearly saw the impact of a recent JCCI study on the St. Johns River. As a sailor on the river, Bailey is a close friend of St. Johns Riverkeeper Neil Armingeon.
“In talking with him, that study has helped him with his struggle to save the river,” said Bailey. “Eighteen months later, (the study) still has an influence.”
Turning some other studies into tangible results has been more challenging, however.
In eight studies on education, Cramer said JCCI has done a “superb” job of outlining the problems and solutions.
“But we’ve had a huge problem implementing the recommendations,” he said. “There’s a great deal of turmoil in the public school system. It’s a vexing issue.”
And while education and race issues continue to be on JCCI’s front burner, Cramer said, “Neither of those is something a task force can solve in two years. It’s generational.”
Funding
JCCI receives the lion’s share of its funding from private donations, but the group also receives money from the City, the United Way and from consulting revenues.
However, the City’s share has dropped significantly in recent years. Cramer said last year the City and other government agencies accounted for about 25 percent of JCCI’s roughly $1 million budget.
“This year the City’s portion is only about 10 percent,” he said. “Unless we can draw significant contract work, we’ll be dipping into reserves. We haven’t had to do that in the recent past.”
To insulate JCCI from the instability of government funding, Cramer hopes the organization can get an endowment for the “core things we do.”
The infant mortality study cost about $100,000 with the advocacy phase adding another $30,000.
Until a year ago, the City of Jacksonville funded half of the study cost.
“That money’s gone,” Cramer said. “We’re having to raise 100 percent of the infant mortality study.”