Lessons Learned from Implementing a Place-Based, Racial Justice-Centered Approach to Health Equity



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.

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This study was supported by W.K. Kellogg Foundation.

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Correspondence to Rebecca Reno.

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Reno, R., Warming, E., Zaugg, C. et al. Lessons Learned from Implementing a Place-Based, Racial Justice-Centered Approach to Health Equity. Matern Child Health J 25, 66–71 (2021). https://doi.org/10.1007/s10995-020-03076-1

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  • Infant mortality
  • Life course theory
  • Place-based approach
  • Social determinants of health
  • Racial and socioeconomic disparities