FLOURISH seeks to achieve large-scale, lasting improvements in the health and well-being of babies and families by impacting entrenched systems that may not be considered traditionally health-related, but are critical to the helping mothers and babies thrive—specifically, transportation. In the area of maternal/infant health, access to medical appointments and consistent medical care is key to healthier outcomes and addressing racial disparities in infant mortality. This project engages new, cross-sector partners in managed care, Metro Transit, medical transportation, and policy advocacy to improve transportation access for two high need zip codes, thereby disrupting the interdependent systems that hinder families’ access to fresh foods, health care, employment, and social services.


BUILD and its communities apply bold, upstream, integrated, local, and data-driven (BUILD) approaches to improve health in communities that are adversely affected by upstream factors.


BUILD provides the first opportunity to leverage input from the Transportation Community Café to launch regional policy advocacy and engage influencers from new sectors (i.e., Metro Transit) in order to impact entrenched systems. Though FLOURISH has established a firm foundation of traditional maternal child health stakeholders, this push upstream fosters commitments from new players and a broader lens to promote racial equity.


In the area of maternal/infant health, and specifically prenatal care, access to medical appointments and consistent medical care is key to healthier outcomes and addressing racial disparities in infant mortality. However, many residents struggle to keep scheduled medical appointments. FLOURISH is actively addressing the complex nature of maternal child health by shaping an environment, through transportation, that is conducive to health and thriving.


Transportation stakeholders newly engaged in FLOURISH are being mobilized in tandem with longstanding partners and local residents by 1) bringing together many different players to address transportation access; 2) reviewing neighborhood level data to address gaps; 3) examining promising practices; 4) engaging the community; 5) developing a system to measure and communicate progress; and 6) building consensus to recognize and define common goals.


This project is driven by work conducted by and with local residents to ensure community-led authority in project decision-making and direction. FLOURISH held 17 maternal health listening sessions attended by over 350 community residents, which revealed barriers like overt discrimination and not being “heard” by providers.  The transportation agenda for BUILD was also guided by the work of local residents engaged in an 8-month facilitated Community Café.


To examine how transportation impacts social and health indicators, data will be linked across sectors, focused on geographical and spatial considerations. Researchers will assess relationships such as the pathways between arranged medical transportation, missed appointments, and birth outcomes. Process measures will identify which program efforts result in proximal changes to transportation systems and will capture community responses to these changes.


Generate Health
SSM Health Care
Mercy Hospital St. Louis
St. Louis Children's Hospital
City of St. Louis Department of Public Health