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Every Baby Guilford

Addressing racial inequities and health disparities in birth outcomes through Collective Action in North Carolina


Every Baby Guilford


Addressing racial inequities and health disparities in birth outcomes through Collective Action in North Carolina


How does a coalition determine a shared purpose with its partners that emphasizes equity and reduces infant mortality disparities?



Thirty years ago, Every Baby Guilford was formed with the mission to reduce infant death and disability through community education and involvement. In doing so, they hoped to increase public awareness of infant mortality, which measures the rate at which a child born alive dies before his/her first birthday.  

However, healthy birth outcomes for women in Guilford County continue to be concerning, especially when taking racial inequalities into account. In 2019, Guilford County’s infant mortality rate was 9.3 per 1,000 births, a 9% increase from 2018. This rate is nearly 37% higher than North Carolina’s rate of 6.8 and 66% higher than the national rate of 5.6. According to 2019 birth data from Guilford County, 66% of infant deaths were African Americans from all socioeconomic levels, making the infant mortality rate for African American infants 2 to 6 times higher than the rate for White and Hispanic infants. In Guilford County in 2019, the infant mortality rate for Black babies was 14.6, while the rate was 6.6 for White babies and 2.3 for Hispanic babies. The County’s pre-term birth rate also has persistent racial disparities with Black mothers having the highest pre-term birth rate at  13.3, compared to White women (9.7), and Hispanic women (8.2).

In Guilford County, the main causes of infant mortality are prematurity, low birth weight, birth defects, and SIDS. 


In 2020, Root Cause worked with Every Baby Guilford to develop a five-year strategic plan grounded in our Collective Action Framework. During the research and planning phase, Root Cause guided Every Baby Guilford in building a robust case for why their work is critical, essential, and urgent. This was accomplished by reviewing existing materials about their purpose and from other similar organizations, understanding local, state, and national discussions on infant mortality and maternal morbidity and identifying gaps in prenatal and perinatal services through stakeholder analysis. Using a radically inclusive process, Root Cause led strategy convening sessions that brought stakeholders together to understand the problem and unique barriers in Guilford County, gain community input and support for the future mission, vision, and activities for EBG, and ensure broad-based community support for the success of future activities. 

Root Cause continues to support Every Baby Guilford in the successful implementation of its strategic plan.

“Infant mortality is a complex and continuing problem that strikes all types of families at any income level, and stems from a variety of health and societal ills [...] In 1988, North Carolina was ranked the worst state in the nation for infant mortality, and we have worked hard over the years to improve birth outcomes”. - Merle Green, Public Health Director in Guilford County
“Since one baby’s death is too many, we must continue to work tirelessly to bring this rate down.” - Sandy Ellington, media coordinator and health educator with the Guilford County Division of Public Health

Goals & Results


Using its new strategic plan, Every Baby Guilford was able to relaunch its work and engage community members, healthcare providers, families, and other stakeholders in combatting the stark disparities in birth outcomes and infant mortality in Guilford County, North Carolina. 

Since 2020, Root Cause has partnered with EBG to improve the key factors driving maternal and infant health outcomes in the county. Root Cause continues to work with EBG’s staff and partners to build the backbone infrastructure and capacity for collective action, provide staff capacity-building support (e.g., staff onboarding and training), and develop the processes necessary for the successful alignment and implementation of EBG’s strategic priorities and interventions. 

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Every Baby Guilford

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