Life’s Course:  The Load, The Impact

Life's Course: The Load, The Impact

Life’s course


Expanding knowledge and understanding of the impact of stress on maternal health.

life’s course


Pre-conception and Maternal Health across Duval County.

Program Description

In collaboration with Northeast Florida Healthy Starts Coalition, Inc, UF Health Jacksonville is embarking on a new initiative; Life’s Course – The Load, The Impact.  This work is seen as additive to the work already underway within the halls of UF Health Jacksonville, Healthy Start Coalition of NEFL and other agencies across the community.

Northeast Florida Healthy Start Coalition, Inc’s Magnolia Project and our own UF Health Jacksonville maternal health team have and continue to work with women across the community to address the rates of mortality.  Through a variety of programs, past and present, data reports and similar activities, their work has been the catalyst to the progress we have garnered in the community.

The goal of the initiative is:

  1. To create/increase awareness of the impact of toxic stress impacting women across the community.
  2. Introduce/increase awareness of the trends in infant/maternal mortality.
  3. Identify coping mechanisms to help reduce the impact of stress on health and well-being. 


Preconception and interconception health are widely recognized as areas of opportunities to mitigate infant mortality.  The number one cause of infant mortality is pre-term births, an underlying contributor to pre-term births is chronic stress. Chronic stress impacts maternal health and evidence shows it was further compounded by the pandemic.  Literature highlights the impact of stress during the COVID-19 pandemic [1, 2, 3].  Stress, also defined as Allostatic load, is a concept introduced in literature, as early as 1993 [4], and refers to the cost of chronic exposure to environmental challenges that is viewed as stressful to individuals [5].

Across Northeast Florida, though infant mortality rates declined between 2017-2021, despite best efforts data shows the gap between African-American and Caucasian women has widened (see Table 1 and Chart A).  In Duval County, the Health Start Coalition of Northeast Florida and other agencies lead excellent initiatives focused on maternal and infant health.  However, an opportunity exists to contribute to this effort to ‘double down’ on efforts and resources to address needs.

While Caucasian women across NE Florida have experienced a decrease in infant mortality, studies regarding the COVID-19 pandemic demonstrate that stress, particularly allostatic load, may have a negative impact on positive trends [3, 4,5].  Moreover, for African-American women, while there is slightly favorable trends, allostatic load may reverse that trend and/or widen the gap between them and Caucasian women. 

Table 1. Infant Mortality Rate by Race, per 1,000 live births

African-american women caucasian women gap
2020 12.75 4.8 7.95
2021 12.25 3.9 8.35

Source:  Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health., Source:

Chart A
Graph: Infant Mortality Rate by Race

Join Us

Are you interested in participating in the program as a participant or a program contributor? 


Checkout our events schedule on our social media pages and sign-up by contacting us.


Contact us below to learn how to share your expertise as a member of the program team.

Contact Us

Urban Health Alliance

Ann-Marie A Knight

Ann-Marie A. Knight MHA, FACHE

Vice President, Community Engagement & Chief Diversity Officer, UF Health Jacksonville
Ross E Jones

LaRae C. Brown M.D., M.H.A., FACOG

Assistant Professor; Medical Director, UF Women’s Health Specialists; Department of Obstetrics and Gynecology; University of Florida College of Medicine – Jacksonville


[1] Abrams Z, High stress levels during the pandemic are making even everyday choices difficult to navigate, American Psychological Association, Vol. 53, No 4, June 1, 2022

[2] Dickens MJ, Pawluski JL and Romero LM (2020) Moving Forward From COVID-19: Bridging Knowledge Gaps in Maternal Health With a New Conceptual Model. Front. Glob. Womens Health 1:586697. doi: 10.3389/fgwh.2020.586697

[3] Thapa SB, Mainali A, Schwank SE, Acharya G. Maternal mental health in the time of the COVID-19 pandemic. Acta Obstet Gynecol Scand. 2020 Jul;99(7):817-818. doi: 10.1111/aogs.13894. PMID: 32374420; PMCID: PMC7267371.

[4] McEwen BS, Stellar E. Stress and the individual. Mechanisms leading to disease. Arch Intern Med. 1993 Sep; 153(18): 2093–101.

[5] 2 Sterling P, Eyer J. Allostasis: a new paradigm to explain arousal pathology. In: Fisher S, Reason J, editors. Handbook of life stress, cognition and health. New York: John Wiley; 1988. pp. 629–49.