Friday Memo- October 25, 2019

Dear Team:

An American scandal is the high rate of maternal deaths from pregnancy-related causes. The United States compares miserably with most other developed nations; a mother in the United States is three times more likely to die from pregnancy related reasons than a woman in Canada. The death rate is far worse for African American women.

The U.S. maternal mortality rate is 18 per 100,000 births. For African American women the mortality rate jumps to 40, a searing indictment of the persisting racial disparities in our country.

Women’s health is at the core of Community Healthcare Network’s mission. A key element of this is providing high quality care to our pre-natal and post-natal patients, giving mothers and their babies the best shot at healthy lives. It requires facing the truth that we must overcome structural discrimination to end racially based health care disparities.

This year, in cooperation with the National Association of County and City Health Officials (NACCHC), CHN launched a project to increase breastfeeding rates among our African American maternity patients.  Breastfeeding improves infant health, and those benefits may well be lifelong. Breast-feeding has many benefits for nursing mothers as well.

CHN’s Women’s Health, Nutrition, and Health Education Departments pulled together a squad to increase our patients’ rate of breastfeeding.  We recognized quickly that the rates of breastfeeding were far too low across CHN’s network.

We also found that, as with national averages, African American mothers were less likely to breast feed.  The squad rolled up its collective sleeves and reviewed CHN’s policies and procedures for patients (and employees), identifying means to maximize support for breastfeeding. The focus on outreach to African American patients was key.

We developed enhanced trainings for medical and support staff, and delivered in person sessions to 80 staff members in June. Our Training and Education Department is now creating a learning module to maintain the training, and to incorporate it into new employee orientation.

According to the newsletter published by NACCHO, CHN’s project “resulted in an increased organizational capacity to provide breastfeeding education, promotion, and support.”

NACCHO said that CHN “will serve as a model for other community health centers seeking to integrate breastfeeding support into routine clinical care.”

We have ways to go, but this initiative shows that CHN is paying attention to the needs of our patients and the social forces that require us to go extra miles to battle against racial disparities in health care.

To Dr. Sharon Griffith, Director of Women’s Health Services, Melissa Olson, Director of Nutrition and Wellness, and Jessica Silk, Director of Health Education: thanks to you and your teams for upping the quality of our care, and for – once more – meeting CHN’s commitment to continuous improvement.


The Joint Commission, that rigorous accrediting body for health care delivery organizations, officially wrapped up its triennial evaluation of CHN last Friday afternoon. The results of the review, in the words of the lead evaluator, were “excellent.”

Among the negative findings, however, was one that I want to pound on during this flu season. CHN was cited for failing to document why certain employees decline to be vaccinated. Public health experts agree that we need that information to fine-tune our employee educational campaign. We must address misconceptions about the safety and importance of the flu vaccine.

A decision to decline the flu vaccine is almost always a bad one. Failure to be vaccinated puts yourself – and your family, friends, co-workers, and our patients – at unnecessary risk. Flu, while always an annoyance, is a killer of tens of thousands of Americans annually.

The Joint Commission’s finding was a reminder of how important our employee flu campaign is. Let’s get to 100 percent vaccination this year — the sooner the better! Please, if you are worried, talk to one of our nurses or providers to answer your questions.


CHN’s Ninth Transgender Health Conference wraps up this afternoon – another smashing success. Yesterday, upwards of 500 participants convened at the New School to understand better the trans experience, the beauty and the challenges, the resources and the brutal unmet needs. Inspiration and commitment were in the air

Today, education sessions are supporting clinicians to increase their skills to provide culturally competent, high quality health care to patients with transgender experiences. We are proud of the leadership that Dr. Freddy Molano and his team bring to the cause of, once again, ending health care disparities for a community too often marginalized and threatened in our current social and political climate.