Guest Post: Infant Mortality and Social Determinants of Health


By Debra Smyers, Sunshine Health

Debra Smyers is the Senior Vice President of Strategic Initiatives at Sunshine Health. She is responsible for utilization management, case management and quality improvement for approximately 1 million Floridians. She has written this guest blog post about Infant Mortality Awareness to share her passion for ensuring every mom and baby has a healthy and happy start. Deb is also a board member of the March of Dimes, Broward.

Moms and babies need our help. The U.S. average infant mortality rate is 5.8 deaths per 1,000 live births, a number that is even higher in Florida, 6.1.*

The best way to prevent babies from dying before their first birthday, which is how we calculate infant mortality, is prenatal care for mothers. At Sunshine Health, we work with groups like the March of Dimes and the Northeast Florida Healthy Start Coalition to support pregnant women and remove the obstacles between them and the care they need.

Too many women do not end up visiting the doctor until well into their second trimester. These same women may not get their recommended annual screenings or well visits before becoming pregnant.

However, it is not that they don’t have a desire to see a doctor or have a healthy baby. These women often face challenges that prevent them from being able to prioritize their health. Most of these are socioeconomic challenges, like lack of transportation, food, childcare or education, also known as Social Determinants of Health (SDoH).

Likewise, SDoH are a factor in unintended pregnancies. A woman may have health insurance, but feeding herself is higher priority than getting to the doctor for family planning. Many women lack familial or spousal support. SDoH is a popular term in healthcare right now, but at Sunshine Health, we have always worked to help members overcome barriers to get the care they need.

The Sunshine Health Community Resource Database connects our members with churches, nonprofits, government assistance and other community groups that can help with resources like job placement and costs for utilities, childcare and housing.

For example, a quick search of our database for Baker County programs brings up NEFL Nurse-Family Partnership, a Northeast Florida Healthy Start Coalition program. Services are provided to high-risk, first-time mothers in high-risk neighborhoods by specially trained nurses. The intent of the initiative is to equip parents and caregivers with the knowledge, skills and tools to assist their children in being healthy, safe and ready to succeed in school. In Jacksonville, the database shows dozens of groups that can assist families with food.

We also work to ensure our members fill out a Notification of Pregnancy as soon as they become pregnant, so we can get them in our Start Smart  for Your Baby ® program, which provides customized support, education and care for pregnant women and new moms.

By addressing SDoH, we can all work together to help to ensure healthy outcomes for moms and babies.

*Source: The Centers for Disease Control and Prevention

Headquartered in Sunrise, Fla., Sunshine Health is among the largest healthcare plans in Florida. Offering coordinated care and a network of support for its approximately 1 million members, Sunshine Health is transforming the health of the community, one person at a time. Sunshine Health is a wholly-owned subsidiary of Centene Corporation and offers government-sponsored managed care through Medicaid, Long Term Care, Ambetter (Marketplace) and Allwell (Medicare). Additionally, we offer a specialty Medicaid health plan for children in or adopted from Florida’s Child Welfare system. For more information, visit or follow us on Facebook and Twitter @SunHealthFL.