What happens when you implement all Ten Steps and center equity? Lives are saved.
Durham County, North Carolina, the first county to implement the Ten Steps to a Breastfeeding Family Friendly Community, saw its infant mortality rate fall 62.3 percent between 2019 and 2024. 2024 was an exceptional year: the rate is expected to rise as more data come in, and BFFC set out expecting a 20 percent reduction. Durham’s comprehensive approach demonstrates the life-saving potential of community-wide infrastructure building.
The Durham Model:
- 300+ organizations committed to the Ten Steps framework
- Equity-centered approach from day one, with targeted support for Black and marginalized families: support that expanded access without ever restricting it. Every service in the Durham model was and is open to all families, which is exactly why the county-wide numbers moved
- Comprehensive systems change across healthcare, childcare, workplaces, and community spaces
- Grassroots organizing that grew from 2 members to 2,000 members
The Results: Overall infant mortality fell sharply. The racial disparity in infant deaths has not closed, and that is the unfinished work.
Durham’s journey shows what’s possible when communities refuse to accept preventable loss and instead build comprehensive infrastructure to support babies and families.
Read Durham’s complete story and see their data →
Ready to adapt this model for your community? Contact us to learn how the Ten Steps framework can create lasting change.