The county Infant Mortality Commission is sending out a survey to about 100 health care providers to try to find out why more women aren't accessing prenatal and perinatal care.
The commission was created by the County Legislature in response to a report that the rate of deaths among African-American babies in Niagara Falls was almost four times the national average for all babies and 4 1/2 times the white infant mortality rate in the city.
"We want to identify the services that are out there," said Burt J. Marshall, the county's social services director, "so we can see whether women who need them are accessing them."
A lack of proper medical care is believed to be a factor in the infant mortality statistics.
The state Health Department reported that of the low birth weight babies who died before their first birthdays in Niagara County, nearly half received no prenatal care until the second trimester of pregnancy or later. And 16.7 percent of the mothers didn't get any prenatal care at all.
"We want a whole category (in the survey) for barriers and service gaps," said Marshall.
Those barriers might include everything from cost to a lack of access to transportation, he said.
The eight-page survey is being sent to doctors, clinics, counselors and substance-abuse agencies, as well as faith-based groups.
"We wanted to send it to more than the usual providers," said county Public Health Director Shirley A. Sampson. "We know the churches provide services in traditional and nontraditional ways."
This is not a countywide survey. Marshall said, "I'm targeting providers who serve women from Niagara Falls."
Legislator Renae Kimble said, "Although we have services available, many people say they are not aware of them. Putting things in the newspaper or in the media doesn't seem to work. These people are struggling to survive. They don't read the paper every day or listen to the news."
Racial factors may enter into the situation. Marshall said some black women may prefer not to visit white doctors or health care providers, and there may be a shortage of black providers.
Another factor is that pregnant women might be reluctant to expose themselves to the health care system because they might not want other factors in their lives to become known, such as drug use.
Meanwhile, Niagara Falls Memorial Medical Center is in the process of hiring community residents to be trained to visit pregnant or nursing women in Niagara Falls' inner city to point them to proper care.
The state awarded the county Social Services Department a $380,000 grant in April to pay for hiring six or seven visitors. Sampson said the visits will likely start in September.
"There's a lot of training involved," she said.
"It's not a program that's intended to be intrusive," said Kimble, whose legislative district includes the areas with the highest infant mortality figures. "They're trying to make sure they're hiring the right people . . . (with) the right disposition, the right demeanor."
Referrals for the home visits are expected to come from doctors, social services caseworkers and not-for-profit community agencies.
Home visit programs have been used in more than 300 communities in 40 states, officials said when the grant was announced.