Public Health Simulation

Welcome to Your Public Health Assignment

Review community health data and design an evidence-based maternal-infant health intervention

Your Role

Position: Public Health Program Coordinator Intern

Supervisor: Dr. Jennifer Kim, MPH, DrPH

Project Duration: 12-month intervention program

Your Mission: Design and implement a community-based intervention to reduce infant mortality by 20% through improved maternal health outcomes.

Program Overview: Healthy Beginnings Initiative

Goal: Reduce infant mortality rate from 10.2 per 1,000 to 8.2 per 1,000 (20% reduction)

Current Mortality 10.2 per 1,000

Target Rate 8.2 per 1,000

Annual Budget $380,000

Target Participants 400 women/year

Community Health Data & Resources

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Infant Mortality by Zip Code

Zip Code	Live Births/Year	Deaths/Year	Rate per 1,000	Median Income
10801	520	9	17.3	$28,400
10802	680	10	14.7	$31,200
10803	440	6	13.6	$29,800
10804	590	5	8.5	$42,100
10805	720	3	4.2	$68,900
10806	650	2	3.1	$74,200

Leading Causes of Infant Mortality

Cause	Deaths/Year	Percentage	Preventability
Prematurity/Low Birth Weight	11	44%	Moderate
Sleep-Related (SIDS)	7	28%	High
Congenital Abnormalities	4	16%	Low
Maternal Complications	2	8%	Moderate

Evidence-Based Interventions

Intervention	Effectiveness	Cost/Participant
Home Visiting	25% reduction preterm	$1,200/year
Safe Sleep Education	40% reduction SIDS	$80 one-time
Group Prenatal Care	33% reduction preterm	$950/pregnancy
Breastfeeding Support	60% increase exclusive BF	$240/participant
Text Message Reminders	28% increase appointments	$45/participant
Community Health Workers	40% increase prenatal visits	$680/participant
Transportation Assistance	35% increase visit completion	$320/participant

Demographics - High-Risk Zip Codes (10801-10803)

Hispanic/Latino: 52%
Primary language Spanish: 46%
Uninsured: 36%
Single-parent households: 44%
Undocumented population: 34%
Teen pregnancies: 18%

Access Barriers (Survey Data)

Transportation (62%): No car, long bus commute
Work schedule (54%): Can't take time off
Language barriers (38%): No Spanish-speaking staff
Insurance/cost (35%): Medicaid pending
Immigration concerns: Fear of seeking services

Section 1: Needs Assessment & Priority Setting

Analyze community data to identify priority populations

Your Task: Analyze infant mortality data and recommend which zip codes to prioritize. You have limited resources - make strategic decisions about where to focus for maximum impact.

Q1: How many total infant deaths occurred in the three highest-risk zip codes (10801, 10802, 10803)?

Q2: What percentage of all community infant deaths occur in these three high-risk zip codes? (Total = 35 deaths)

Q3: Which cause of infant death is BOTH highly prevalent AND highly preventable?

Q4: Needs Assessment Summary - Justify your priority population and intervention focus (150+ words)

Section 2: Program Design & Cultural Competency

Design evidence-based, culturally appropriate interventions

Budget: $380,000 to serve 400 participants ($950/participant for interventions)

Population: 52% Hispanic, 46% Spanish-speaking, 34% undocumented

Barriers: Transportation, language, work schedules, immigration concerns

Q5: If you implement safe sleep ($80) + breastfeeding ($240) + text reminders ($45) for all 400 participants, what is total cost?

Q6: Which intensive service provides BEST cost-effectiveness for reducing preterm births?

Q7: For 46% Spanish-speaking population, which staffing approach is MOST culturally competent?

Q8: Program Design Rationale - Explain intervention selection and cultural approach (150+ words)

Section 3: Community Engagement & Partnerships

Build trust and collaborate with stakeholders

Challenge: After 8 weeks, only 32/80 target women enrolled. Exit interviews reveal:

"Worried about immigration consequences"
"Don't know anyone who's done it"
"Not for people like me"

Q9: Given 34% undocumented population, which partner builds MOST trust?

Q10: To reach women early in pregnancy, which outreach strategy leverages community trust MOST?

Q11: How should you integrate community doulas to maximize trust AND effectiveness?

Q12: Community Engagement Strategy - How will you rebuild trust and increase enrollment? (150+ words)

Section 4: Evaluation & Outcomes Measurement

Design evaluation plan and calculate impact

12-Month Results (High-Risk Zip Codes 10801-10803):

Enrollment: 380 participants (95% of 400 target)
Live births: 1,640 (baseline: 1,640)
Infant deaths: 18 (baseline year: 25)
Baseline mortality rate: 15.2 per 1,000

Q13: What is the new infant mortality rate after intervention? (deaths / births) × 1,000

Q14: What percentage reduction in mortality was achieved? [(baseline - new) / baseline] × 100

Q15: Did the program meet its 20% reduction goal?

Q16: If each infant death costs $400,000 (NICU, complications), what were cost savings? (prevented deaths × $400,000)

Q17: What is the ROI? [(savings - cost) / cost] × 100

Q18: Evaluation Report - Summarize outcomes and scaling recommendations (150+ words)

Your Public Health Program Results

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out of 100 points

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Section 1

Needs Assessment

--/25

Section 2

Program Design

--/20

Section 3

Community Engagement