Hamilton County's infant mortality rate dropped below the national average in 2023 for the first time since record keeping began in 1968. The county's Black infant mortality rate also achieved a milestone, dropping to a single digit for the first time.
"When Cradle Cincinnati formed in 2013, Hamilton County families were 70% more likely to experience infant loss than families across the nation," says Meredith Smith, Ph.D., executive director of Cradle Cincinnati. "To now be lower than the national average speaks to the power of our community coming together and applying persistent and innovative approaches to solving infant mortality."
The infant mortality rate is the number of babies who die before reaching their first birthday, per 1,000 live births. In Hamilton County in 2023, 55 babies died out of 10,026 births for a rate of 5.5 — a historic low for the county and the first time the number has dipped below the national average, which inched up 3% in 2022 to 5.6.
"We have reached a very important milestone of a 5.5 IMR (infant mortality rate) for our county, and we're very excited about that because we set out with a very lofty goal to reach the national average," says Dominique Walker, senior data management specialist with Cradle Cincinnati. "We're very excited that we have gotten to this milestone, and we're looking forward to the work to come."
Cradle Cincinnati was created as a collaboration between Hamilton County, Cincinnati, and local health departments, medical systems and community groups to focus on reducing Hamilton County's high infant mortality rate. In 2019, the organization shifted its efforts to focus on Black women. Last year, it released a five-year strategic plan aimed at reducing Black infant deaths.
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The Black infant mortality rate dropped in 2023 to 9.0.
"That one is a tremendous step in the right direction," says Walker.
Among many efforts, the agency has implemented programs such as Queens Village, which groups Black women together to share their experiences and find supports; and Mama Certified, a certification program for hospitals that provides Black families with a meaningful way to assess and compare the maternal-related efforts of local birthing hospitals as well as encourage and support hospitals' increased efforts to ensure Black parents-to-be and their babies receive respect and care.
That program grew out of understanding the effects of racism that have become embedded in the health care system, creating racial disparities in treatments and outcomes.
"We knew that we had to really focus on centering Black mom's voices, but putting some focus on our Black infants and the Black infant mortality rate. Collectively, we've seen that working together is really helping us achieve these goals, and so having a single-digit Black IMR is just a huge step in the right direction of the work that's being done in our county," says Walker.
The most stubborn numbers over the last few years have been preterm births and sleep-related deaths. Preterm birth-related deaths once accounted for the majority of infant deaths. After an increase last year, that number (for overall births) decreased in 2023.
Sleep-related deaths also decreased, but are still a major factor in the county's IMR. Black families are five times more likely to lose an infant in a sleep-related death than white families. Cradle Cincinnati has increased messaging around the ABCs of safe sleep — that babies sleep best Alone, on their Backs, and in a Crib — but Walker says the agency needs to come up with more innovative ways to get the message out there.
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"The biggest thing that we're doing is trying to connect with families and hear what else is impacting how they're practicing sleep, and trying to be cognizant of that. We know, as we've talked with our community, they're aware of the ABCs, but there's other things that factor into how they practice sleep."
Walker says in working with and hearing from Black moms in focus groups, the agency has identified some of the challenges.
"Some of the things that are coming out are lack of support, exhaustion, postpartum depression, stress, financial barriers and (other) things."
She says the next step is figuring out ways to support parents in those needs.
