P3B143: Adequate Housing: major Social Determinants of Health Need of Women Enrolled in Prenatal Care in One Eastern North Carolina Rural Community

Background: In 2018, I received a CATCH (Community Access to Child Health) AAP grant for a proposal to evaluate the Social Determinant of Health needs of women enrolled in prenatal care in the public and private sectors. Our community is located in rural eastern North Carolina and over 30% of our children live in families who are below the federal poverty guidelines.

Project Description: I organized a community coalition in order to bring public health staff, hospital women and infants care staff, social services administrators, obstetrical providers, pediatric providers, and agency leaders who are addressing Social Determinant of Need issues in our community (food insecurity, transportation barriers, housing inadequacy, substance abuse, mental health disorders, domestic violence) with a goal of improving interagency communication among various agencies, and to identify issues affecting women in prenatal care that might require ongoing attention from the larger community.

Discussion: Our community-based coalition met monthly for 15 months and assured that the information gathered in the prenatal clinics in the public and private sectors would be shared with hospital labor/delivery/newborn nursery/postpartum staff, and essential information concerning the babies and their families would be shared with the child health professionals who would assume care of the babies upon hospital discharge. The coalition identified inadequate housing as the major social determinant need of women in prenatal care, documenting that women needing better housing would have to be referred out of the county for necessary support. We further found that, on a given day, 250 children in our public schools (student enrollment 19,000+) met the definition for homelessness.

Conclusion: Our leadership group communicated this information to leaders in City and County government and I made a presentation to the City Council about our findings and our opinion that I the City had received from the federal government during the COVID 19 pandemic, that could be used to address the needs of the homeless, should be applied toward the cost of purchasing a 60-bed former nursing home that could become a multidisciplinary center for addressing the needs of the homeless. The City elected to ask the United Way to evaluate the homelessness situation and come back to the City with a formal recommendation for expenditure of the federal money. I serve on the Board of United Way and will be involved in all this decision making in the coming months. I expect the homelessness multidisciplinary center will become a reality for our community, thanks to the momentum gained during our CATCH project discussions.