ROCHESTER — The impact of an Olmsted County Public Health Services program goes back years.
“I utilized the resource when our first child was born” about 18 years ago, said Julie Ruzek, executive director of Cradle 2 Career. “It was so amazing, and so I’ve always been so glad that it exists.”
That program is
Family Home Visiting,
a no-cost program for qualified families. Starting as early as pregnancy, public health nurses visit families’ homes on a regular schedule to support their basic needs and their child’s development through kindergarten.
“They provide a lot of education to parents,” said Sarah Stevens, an OCPHS nurse manager who oversees the Family Home Visiting program. “It can be from how to play with your child, what does feeding look like, how to prepare for the next stage of the child’s growth and development.”
This county program, along with a partnership with Cradle 2 Career to improve access to prenatal care, was recently recognized with the Minnesota Department of Health’s Betty Hubbard Maternal and Child Health Leadership community award.
“To receive it with a partner and to know that alone, we could never have done this, but together, we’re taking steps in the right direction,” Ruzek said.
The prenatal care partnership started when leaders with county public health and the community childhood investment initiative learned that they were both researching the same disparities in care for pregnant parents, babies and toddlers.
“We knew that with their focus on education outcomes and our focus on health outcomes,” Stevens said, “what a perfect way to work together and achieve the same results.”
This spring, the partnership produced its
Prenatal Care Access Community Co-Design Report,
which explores the barriers local residents may face when getting health care during pregnancy.
Despite the community having a medical powerhouse at its center, the report found that expectant parents in Olmsted County were less likely to receive adequate prenatal care during their pregnancies compared to Minnesotans overall.
The gaps in prenatal care access were most pronounced in three groups of pregnant people: those who are aged 15-19, those who are Black or African American and those without a high school diploma.
Then, the partnership brought in its co-designers, a group of county residents who were part of at least one of those three most affected groups.
“We asked and invited them to tell us their experience, and then to work with their communities in between our meetings — they went out and talked to whoever was in their community about these same issues, and then brought that back to the table as well,” Ruzek said.
The most common barriers to prenatal care, the team found, centered around transportation, emotional support, trauma-informed care and relationships with family members, partners or medical providers. These categories encompass a wide range of potential ways a person’s prenatal care could be impacted.
“People want to talk about transportation because it’s very concrete — a pregnant person who needs to get to their appointment, let’s just help them with transportation,” Ruzek said. “What we’ve learned is, yes, transportation is one barrier, but maybe the pregnant person hasn’t told their family yet that they’re pregnant, so they can’t ask someone for a ride. … There’s many layers of the onions to peel back.”
What interventions and solutions are needed in this space are yet to be determined — the co-design group will meet again soon, Ruzek said, to explore some strategies. Whatever the solutions may be, Ruzek said they want them to create a difference in the long term.
“It took years for these systemic inequities to grow and exist,” Ruzek said. “It’s going to take some time to undo them and to improve them. … A quick fix does not address the root of the issue.”
