Green Paper

Download PRIME Green Paper (PDF)

A green paper is written to frame a discussion and debate on a particular topic, usually representing a range of ideas, and invites interested individuals to share their views, perspectives, and expertise on a given topic (CDC, 2008). The purpose of the PRIME Green Paper, written by colleagues at the University of Michigan, School of Public Health in collaboration with Steering Team Members, is to:

  • Characterize the nature of racial health disparities in infant mortality in Michigan between African Americans and Whites and between American Indians and Whites
  • Describe how social determinants of health shape the patterns and persistence of these disparities
  • Distinguish the roles and responsibilities of a state health department from that of other institutions and entities in our public health system
  • Provide an overview of existing training and intervention approaches and argue for the need to create a model that addresses the unique needs of a state health department in addressing racial disparities in infant mortality
  • Serve as a springboard for discussion among the PRIME team to redefine the project's aims, goals and objectives
  • Suggest a series of next steps to describe how the MDCH Bureau of Family & Maternal Child Health and the PRIME Steering Team will move forward to create a new strategy to reduce racial disparities in infant mortality in Michigan.

The PRIME green paper investigated trends in infant mortality in Michigan by using the Perinatal Periods of Risk (PPOR) Framework, which categorizes fetal-infant mortality into four areas that correspond to prevention areas to guide intervention efforts. The four PPOR categories are: maternal health/prematurity, maternal care, newborn care, and infant care. For more information, please see the full green paper (PDF). Through using the PPOR lens of analysis, researchers at the University of Michigan concluded that infant deaths occur in different frequencies within these four labels between African Americans, American Indians, and the reference group. For more information about infant mortality in Michigan, click here .

In addition to examining the problem, the paper explored the reasoning behind our call to address racial disparities in infant mortality. The Three Core Functions and the Ten Essential Services of Public Health provide some guidance but do not specify the necessary tasks and role of state health department in pursuing these core services.