In West Contra Costa County, California, where Black babies still die at two to three times the rate of white babies, a 35-year-old state program is only as effective as its most practical detail: whether a mother can bring her toddler along.
Contra Costa County is contracting for ChildWatch services to provide supervised on-site childcare during sessions of the Black Infant Health (BIH) program, which serves Black pregnant women and mothers with infants up to six months old, mostly in Richmond. Without someone to watch older children during the program's 10-week group curriculum, many participants simply can't attend. The program, funded by the California Department of Public Health, uses group-based, culturally affirming sessions focused on stress reduction and prenatal-to-postpartum support. If the childwatch slot goes unfilled, the sessions stall.
BIH has operated in California since 1989, created after data showed Black infants were dying at roughly twice the rate of white infants statewide, a gap that has never closed. Today the program runs in 15 counties with large Black populations, including Contra Costa, where the disparity has historically been worse than the state average. Richmond and neighboring San Pablo, the program's home territory, carry the legacy of redlining, industrial pollution from the Chevron refinery and decades of disinvestment that researchers consistently link to worse health outcomes.
Source: NationGraph.
The urgency behind the work has grown in recent years. The COVID-19 pandemic pushed Black maternal and infant mortality higher nationally. In 2022, California passed the Momnibus Act, expanding Medi-Cal coverage for doulas and requiring implicit bias training for perinatal care providers. That same year, the Biden administration released a federal blueprint targeting maternal health. Contra Costa's Board of Supervisors had already declared racism a public health crisis in 2020, formally tying the county to equity-focused health investment.
This particular contract is a recurring procurement, not the launch of something new. But the need it addresses is as current as the latest mortality figures. A provider will be selected to handle childwatch logistics so that BIH group cohorts can run without interruption through the coming program cycle.
