Long before COVID-19 arrived in the United States, people with lower incomes had long suffered from poorer health than their more affluent neighbors. The pandemic has increased this problem, and women — particularly women of color — have carried a disproportionately severe burden because of heavier responsibilities for family care and higher rates of job loss.
Recognizing the urgent need to ensure the health of women in our communities, Women’s Health Research at Yale and Elevate, the university’s health policy lab, are collaborating to deploy interventions grounded in the latest and most reliable research directly to women and families.
“I am just over the moon about this initiative,” said Diane Young Turner, a member of WHRY’s Advisory Council. “We are seeing women in our communities suffering because they struggle to feed their families or because they cannot provide educational support for their kids or because they cannot work. To have WHRY and Elevate advancing solutions backed with scientific research is very encouraging and exciting.”
WHRY and Elevate collaborate to generate and leverage research to test practical methods for addressing the urgent health needs of under-resourced and overburdened pregnant and parenting women. By alleviating the disability associated with poor mental health through the data-driven Mental health Outreach for MotherS (MOMS) Partnership interventions, women are able to rejoin the workforce, their children benefit at school and at home, and the potential exists to disrupt the cycle of poor health and poverty.
“We have data that show significant economic results for caregivers,” Turner said. “We have made a difference in these communities. And if we can continue to scale that up, then we can really begin to deal with these problems. Because they are not going to go away on their own.”
Elevate has expanded the MOMS programs from New Haven to Washington, D.C., Vermont, Kentucky, New York, and Bridgeport, Conn. New programs are soon to be rolled out in other states.
“When you think about poverty in an urban city like Bridgeport, it’s essential to realize that the degree of poverty requires 99 percent of children to receive free lunch,” said Dr. Monette Ferguson, Executive Director of the Bridgeport-based nonprofit anti-poverty agency Alliance for Community Empowerment (ACE), a Bridgeport MOMS partner. Under Dr. Ferguson’s leadership, ACE serves over 35,000 individuals a year. “That is a very impoverished community, which we also know does not have easy or affordable access to mental health resources.”
Dr. Ferguson sees the clear value in working with partners — such as the Rev. Nancy Kingwood at GBAPP and Deborah Sims with East End Pop-up Market — to integrate the MOMS program into their community.
“To me it was very clear if this were to work in any community, it needs to become braided into the fabric of something that has already existed,” Ferguson said. “We want to offer MOMS along with other available resources. Then we can refer clients to MOMS as a matter of practice, break down stigmas regarding mental health, and create a culture of wellness.”
Fundamental to this approach, Elevate’s research has demonstrated the value of employing Community Mental Health Ambassadors (CMHAs) — mothers from the local communities who join the paid MOMS staff to accompany participants on the journey to improved well-being.
“We understand the importance of the CMHAs in reaching out and making that connection with mothers who, since the start of the pandemic, are more isolated than they were before,” said Hilary Hahn, Executive Director of Elevate. “These ambassadors are crucial in helping some mothers overcome a sense of hesitancy in joining MOMS, particularly in dealing with the process of joining remotely via the internet during the pandemic.”
Women’s Health Research at Yale has demonstrated for 23 years the value of empirically tested methods and welcomes the addition of carefully analyzed qualitative data gathered through scientifically developed questionnaires. Dr. Keitra Thompson, a nurse practitioner and postdoctoral fellow working with Elevate, is conducting a qualitative evaluation of the MOMS sites to learn from participants’ descriptions of their experience.
“Those with lived experience have the greatest insight into what they need, what they lack, and what they received that provided a path ahead,” Thompson said. “We get to hear directly from them about what they found beneficial in the program and how it has helped them find jobs, better parent their children, and move forward.”
Dr. Thompson expressed hope that Elevate can continue to demonstrate the efficacy and cost-effectiveness of the MOMS programs, so it can spread to the many communities where such services are needed.
“The women I speak with are glad that MOMS now exists in their communities,” she said. “They need the skills and support it provides so they can address mental health and stress in their lives. They want to parent as effectively as they can, and they need to feel the self-efficacy and personal ability to further their goals and get past some of these barriers in front of them.”
As with all Elevate and WHRY initiatives, the data will be used to examine success in reproducing the programs in different venues and at costs that leverage existing social service programs in ways government policymakers find attractive. The Bridgeport project includes a collaborative partnership with Connecticut’s Department of Energy and Environmental Protection, as part of its commitment to simultaneously addressing the health, environmental, and economic challenges that underlie health disparities.
“This partnership is a great model for us,” said Hilary Hahn, Elevate’s Executive Director. “Many communities are struggling with these issues, and there are diverse local, state, and federal resources that can be tapped to help.”
Dr. Ferguson applauded the efforts as a timely, necessary, and wholistic approach to a growing need.
“Mothers might start coming to us for food assistance and childcare, but when we get to know these families, we see a tremendous need for mental health resources,” Ferguson said. “Now we will be able to provide that for them, like the generations of families who have come to us for help, seeking not a hand out, but a hand up.”