School of Public Health, University of California, Berkeley, Berkeley, USA.
Matern Child Health J. 2021 Jan;25(1):66-71. doi: 10.1007/s10995-020-03076-1. Epub 2020 Nov 26.
As theories about the causes of racial inequities in infant mortality evolve, they are becoming increasingly complex. Interventions to address these inequities must be similarly complex, incorporating both upstream and downstream approaches.
The Best Babies Zone Initiative (BBZ) has been in operation since 2012 with an aim of reducing racial inequities in infant mortality. BBZ is designed to be flexible and responsive to the conditions creating toxic stress in communities of color. After seven years of operation in nine sites across the United States, and interventions implemented in housing, economic, and environmental justice, the Initiative has identified strategies to support the development and advancement of aligned programs.
Lessons learned and opportunities were identified across the Initiative's theoretical foundation (the life course perspective) and each of the four foundational strategies: place-based, community-driven, multi-sector work that contributes to broader social movements. Overarching lessons learned about advancing equity in MCH were identified including: the need to focus explicitly on racial equity, the imperative of shifting the time horizon for change, and the importance of identifying sustainable funding mechanisms.
A complex initiative such as BBZ is relatively nascent in the field of Maternal and Child Health. However it represents an innovative approach to building community power and fostering strategic organizational partnerships in service of addressing root causes of racial inequities in birth outcomes. The lessons learned and opportunities identified by BBZ can serve as a foundation from which to build other programs and initiatives to advance racial justice.
随着关于婴儿死亡率种族不平等原因的理论不断发展，这些理论变得越来越复杂。为了解决这些不平等问题，干预措施也必须同样复杂，包括上游和下游方法。
最佳婴儿区倡议（BBZ）自 2012 年以来一直在运作，旨在减少婴儿死亡率方面的种族不平等。BBZ 的设计灵活，能够应对造成有色人种社区毒性压力的条件。在美国九个地点开展了七年的业务，并在住房、经济和环境正义方面实施了干预措施后，该倡议确定了支持相关计划发展和推进的战略。
在倡议的理论基础（生命历程视角）和四项基础战略（基于地点、社区驱动、为更广泛的社会运动做出贡献的多部门工作）方面都确定了经验教训和机会。在孕产妇和儿童健康方面推进公平方面确定了总体经验教训，包括：需要明确关注种族公平、改变变革时间框架的必要性，以及确定可持续供资机制的重要性。
像 BBZ 这样复杂的倡议在母婴健康领域还相对较新。然而，它代表了一种创新的方法，可以建立社区权力，并促进战略组织伙伴关系，以解决出生结果中种族不平等的根本原因。BBZ 确定的经验教训和机会可以作为建立其他计划和倡议以推进种族正义的基础。
