Infant mortality

HPIO report summarizes maternal, infant health outcomes from Columbus housing project

The Health Policy Institute of Ohio recently completed a final report summarizing the outcome and process evaluation results of CelebrateOne's Healthy Beginnings at Home (HBAH) housing stabilization pilot program, which is designed to improve maternal and infant health outcomes for families with low incomes in the Columbus area. A nine-page executive summary and a longer final report are available. 

The report includes five key findings and 16 recommendations and policy changes to strengthen HBAH replication and improve housing and health outcomes for pregnant women and their families. Insights from the evaluation can be valuable for other programs in Ohio that aim to improve maternal and infant health through housing interventions. 

This report builds upon the following work: 

Maternal morbidity higher in majority-Black neighborhoods, study finds

People who live in majority-Black neighborhoods have a higher likelihood for maternal health complications, according to a study released earlier this month (Source: “Majority-Black Neighborhoods See Maternal Health Disparities,” Patient Engagement HIT, April 13, 2021).

The new data from Penn Medicine, published in Obstetrics and Gynecology, found a 2.4% increase in maternal morbidity for every 10% increase in Black residents within a given neighborhood.

Previous data has shown that maternal morbidity, or any unexpected labor outcome with major long- or short-term consequences, have a disproportionate impact on Black women compared to white women. This health disparity exists even after controlling for factors such as education level and income, prompting many health equity experts to consider the role that structural racism and implicit bias can play in health outcomes.

“This study gives us a blueprint for addressing racial disparities in health care at the neighborhood and population-level,” said co-author Lisa Levine, MD, an assistant professor of Obstetrics and Gynecology at Penn. “Investing in neighborhoods that have been historically segregated, lacked access to government services, and subjected to racism will help to improve not only severe maternal morbidity, but also a host of other health outcomes for patients.”

Addressing racial disparities in infant mortality requires dismantling structural racism

Black babies in Ohio are born too early and too small — factors that contribute to dying before their first birthdays at a rate twice that of white babies (Source: “Black babies dying at alarming rate: How can their lives be saved?,” Dayton Daily News, March 14, 2021).

While disparities in income and educational attainment play a role, Black mothers with higher incomes and education are still more likely to live in disadvantaged neighborhoods, face biases from health care professionals and toxic stress from racism that erodes health on a cellular level, according to the Health Policy Institute of Ohio. Some research indicates the health impacts of that stress can be passed on.

Policymakers need to dismantle structural racism with reforms that create equitable access for communities of color to housing, jobs, education and quality, less-biased health care, say experts at HPIO. In the short-term, local groups should continue connecting minority and at-risk moms with assistance services.

HPIO fact sheet outlines actions needed to eliminate racial disparities in infant mortality

HPIO has released a new fact sheet titled “Taking action: Eliminating racial disparities in infant mortality.”

The fact sheet highlights that, “For many years, Ohio’s infant mortality rate has been higher than most other states... Ohio’s policymakers and health leaders have acted on this issue through multiple advisory committees, collaborative efforts, investments, legislation and other policy changes.”

In December 2020, Gov. Mike DeWine announced the creation of a new task force focused on eliminating racial disparities in infant mortality by 2030. The task force will host listening sessions in 11 counties, providing an opportunity for members to learn about promising programs, evaluation results and barriers to improving maternal and infant health for Black families.

The fact sheet includes troubling infant mortality disparities data and information on what can drive change and move Ohio forward. It highlights three action steps that are needed to eliminate racial disparities in infant mortality. Future efforts must:

  • Dismantle racism and address its consequences
  • Improve health across the life course, not just pregnancy
  • Maintain improvements in access to clinical care, while also advancing meaningful policy changes to improve community conditions

Overall infant mortality rate drops in Ohio, racial disparity increases, report finds

Black babies are dying before their first birthday in Ohio at an even greater rate — nearly three times that of white infants — even though the state's overall infant mortality rate was unchanged last year (Source: “Despite years of efforts to combat infant mortality in Ohio, racial disparity increases,” Columbus Dispatch, Dec. 17).

The data released on Thursday in a report by the Ohio Department of Health show that racial disparities are getting worse, despite years of efforts to close that gap and reduce infant mortality.

The report prompted Gov. Mike DeWine to announce the formation of a new task force charged with developing a plan to reduce infant mortality and eliminate the racial disparity by 2030.

While the state reported that the 929 babies who died before their first birthday in 2019 (down slightly from 938 a year earlier), the state's 6.9 infant mortality rate — the number of babies who die before their first birthday per 1,000 live births — was unchanged because fewer babies were born last year.

Among black babies, the infant mortality rate increased, though, to 14.3, up from 13.9 a year earlier, according to the report. That's nearly three times the 5.1 infant mortality rate for white babies.

Ohio infant mortality rate declines, racial disparities persist, state data shows

The Ohio infant mortality rate continued to improve in the latest state report, though a wide gap still remains between the rate of black and white babies who make it a year to celebrate their first birthdays (Source: “Ohio infant death rate declines but still remains above national rate,” Dayton Daily News, Feb. 26, 2020).

According to the Ohio Department of Health’s 2018 Infant Mortality Annual Report, Ohio’s infant mortality rate — the number of babies who die before age 1 per 1,000 live births — was 6.9 for 2018, the Ohio Department of Health said Tuesday. That is higher than the 2017 national rate of 5.8.

The Ohio rate has declined from 7.2 deaths per 1,000 births in 2017 and 7.4 in 2016. The rate among black infants fell to 13.9 in 2018 from 15.6 in 2017. Ohio’s goal (as outlined in the 2017-2019 State Health Improvement Plan) is 6.0 or fewer infant deaths per 1,000 live births in every racial and ethnic group.

“While there are indications of promising progress, there is much more that we must do to help more Ohio babies reach their first birthdays, particularly African-American infants given that the black infant mortality rate hasn’t changed significantly since 2009,” said Gov. Mike DeWine, who has made infant mortality prevention a top priority.

Preliminary data shows drop in Ohio infant mortality rate

Preliminary data from the Ohio Department of Health shows that in 2018, Ohio’s mortality rate has dropped from 7.2 to 6.9 (Source: “Preliminary data show infant mortality rate decline in Ohio,” Dayton Daily News, Sept. 28, 2019).

“This shows some progress from 2017, which is promising; however, we know that this number is far, far too high,” said Reem Aly, vice president of HPIO at the annual Their Story is our Story Infant Mortality Conference at Sinclair Community College in Dayton. “So while we’re moving in the right direction we certainly cannot stop, and there needs to be a much more aggressive intention and approach across our state.”

Since 2010, more than 8,200 Ohio babies have died before turning one. There were 982 Ohio infants who died in 2017 before their first birthday last year, down 42 from 1,024 infant deaths in 2016, according to ODH.

Black babies continue to die at a rate more than 2.5 times higher than white babies in Ohio, according to the preliminary ODH data.

The state has invested around $137 million in tackling infant mortality over the last eight years. That investment has been used to primarily target nine Ohio counties that accounted for around 66 percent of all infant deaths last year and 90 percent of black infant deaths, ODH reported.

Ohio House passes bipartisan bill to combat infant mortality

With an eye on decreasing the state’s high infant mortality rate, the Ohio House passed a bipartisan bill Thursday that would expand smoking cessation, dental visits and health and lead education (Source: “Ohio House approves spending $11 million to reduce infant mortality, preterm births,” Cleveland Plain Dealer, June 20, 2019).

House Bill 11, sponsored by Rep. Gayle Manning, a Republican from North Ridgeville, and Rep. Stephanie Howse, a Cleveland Democrat, passed unanimously. It now heads to the Senate.

HB 11, if passed, would have four components:

  • Require Ohio Medicaid, Medicaid managed care organizations and state employee insurance plans to cover federally recognized tobacco cessation medications and services.
  • Provide $6 million to the Ohio Department of Health to give grants to health care facilities, medical practices and others to begin programs that encourage early prenatal care.
  • Provide $5 million for pregnant Medicaid recipients to receive twice-a-year dental visits.
  • Require the Ohio Department of Health to develop educational materials on lead-based paint and distribute them to people who live in homes built before 1979 and to families who participate in the state’s Help Me Grow Program.

Cleveland to launch HUB model to combat infant mortality

Cleveland is in line to become the next Ohio city to adopt the Pathways Community HUB model to combat infant mortality (Source: “Plans underway to launch successful “HUB” model to combat infant mortality in Cleveland,” Cleveland Plain Dealer, April 3, 2019)

Plans are underway to bring a successful “pay for performance” model called Pathways Community HUB to Cleveland, according to the nonprofit healthcare improvement organization, Better Health Partnership.

The organization is working with the city-county infant mortality coalition, First Year Cleveland, as well as other local public health agencies, to design a HUB for the city, Better Health Partnership said in its March newsletter.

The HUB model, first launched in Mansfield in the 1990s to reduce the number of babies born too small and too soon in that city, uses a “pay-for-performance” model to reimburse community health workers who work with high-risk women based on meeting certain objectives. The HUB itself acts as “air traffic control” for the many local agencies involved in the care of pregnant women and families to coordinate pay, often through managed care plans or local health departments, and for referrals.

The model, which also has been used to address social issues such as human trafficking and substance abuse, has been deployed in eight states and at least five other Ohio cities. In the summer of 2015, the Ohio Department of Medicaid and the Ohio Commission on Minority Health (OCMH) gave $4 million to expand the state’s existing HUBs and launch new ones in Akron, Youngstown and Columbus.

The model has so far delivered impressive results in the area of infant health: in Mansfield, where the HUB has been operating the longest, women who participated delivered low-birth-weight babies at less than half the rate of those at the same risk level who did not participate. Researchers estimate that each dollar invested returns more than $3 in short-term healthcare costs and $5 in long-term costs, from neonatal intensive care unit stays to emergency room visits.

ODH: Infant mortality down overall in Ohio, up for black babies

New data released this week found that while the number of Ohio babies who died before their first birthday dropped by 60 last year, from 1,024 to 982, the number of deaths among black infants rose by 15 (Source: “Ohio infant deaths fall overall, but rate for black babies increase,” Columbus Dispatch, Dec. 6, 2018)

The rate for white babies was 5.3 per 100,000 births; it was 15.6 for blacks. Ohio’s goal is 6.0 infant deaths per 1,000 live births for all racial and ethnic groups, according to the latest data from the Ohio Department of Health.

“The data show we are helping more babies in the state reach their first birthdays, but we still have a lot of work to do — particularly in eliminating racial disparities in birth outcomes,” said Lance Himes, director of ODH.

Nine urban counties, including Franklin, accounted for nearly two-thirds of all infant deaths last year and 90 percent of black infants’ deaths. Ohio’s 982 infant deaths last year marked the second time that the annual total has been below 1,000 since the state began counting in 1939. The first time was in 2014, when 955 babies died.