In a setback for local efforts, Hamilton County's infant mortality rate increased in the last two years.
Cradle Cincinnati reports the rate at which babies die before their first birthday has increased since 2023, and the infant mortality rate for Black babies more than doubled in the same time period. The agency released the 2025 numbers Tuesday.
"We are once again seeing significant increases, and that’s something that should alarm every one of us," says Meredith Smith, Ph.D., executive director of Cradle Cincinnati, in a release. "We are calling on every business leader, faith leader, elected official, healthcare provider, neighbor, and community partner to come to the table and commit to our moms and babies. We can turn this around, but it will take us all."
The infant mortality rate is the number of babies who die before reaching their first birthday, per 1,000 live births.
In Hamilton County, the overall infant mortality rate increased to 9.3 in 2025, up from 5.5 in 2023, which was an all-time low. The Black infant mortality rate went from 9.0 in 2023 to 21.0 in 2025. On the whole, however, there are still fewer infant deaths now than a decade ago.
The agency says preterm birth-related deaths accounted for the sharpest increase among Black babies, rising from 12 in 2023 to 22 in 2024 and 26 in 2025. Overall, extreme preterm birth remains the leading cause of infant death, accounting for nearly half of all infant deaths.
What's causing the rise?
Unsafe sleeping arrangements such as parents co-sleeping with their babies increased from 15 deaths in 2023 to 22 deaths in 2025. According to the report, 73% involved the baby sleeping next to another person, and 55% involved the infant sleeping in an adult bed.
Experts note that babies should sleep Alone, on their Backs, in a Crib (otherwise known as the ABCs of Safe Sleep). Babies should not sleep on regular beds because the mattresses are too soft and can make it hard for them to move if they get in a distressed position. Likewise, you should keep excess blankets and stuffed animals out of cribs so as not to create potential breathing or movement impediments.
Reasons for disparities unclear
Dr. James Greenberg, Cradle Cincinnati co-founder and co-director of the Perinatal Institute at Cincinnati Children's, says the disparity between Black and white infant sleep-related deaths has grown dramatically, and it's unclear why Black babies are disproportionately affected.
"Anyone who's had a baby or been around someone who has had a baby knows that it's exhausting, that you need support, both in terms of people and in terms of finances," he says "It appears that the Black women in the county are disproportionately experiencing those kinds of challenges. Why? Can't tell you right now. [There are] a lot of ideas, but those ideas are just ideas at this point, but certainly, support for maternity leaves and various kinds of social service or safety net services have been really frayed around the edges, if you will, over the last few years."
In 2023, the 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 that year, dropping to a single digit for the first time.
According to Cradle Cincinnati, Black babies are 79% more likely to die before age 1 than babies overall in Hamilton County. The agency points out that the healthcare industry has historically marginalized Black women's health and concerns. Black women are also less likely to receive family planning and reproductive health services. All of this results in mistrust, poorer care, fewer people seeking pre- and post-natal care and worse outcomes.
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. It released a five-year strategic plan in 2023 aimed at reducing Black infant deaths.
The organization and local health leaders say they'll continue to push for better outcomes and more support and resources to prevent infant deaths. They point to existing programs including Queens Village, the Pregnancy Pathway Program, and Cribs for Kids, which will provide a free Pack-N-Play-style playard (travel crib).
Greenberg says a pilot program through Queens Village that places a team member in maternity waiting rooms and other healthcare spaces to connect with expectant parents has been showing success. The organization hopes to expand it to Good Samaritan from UC Medical Center and the Cincinnati Health Department.
"Queens Village Corner is an effort to really merge [public health workers and private healthcare] by embedding individuals in waiting rooms at maternity centers and maternity healthcare settings to provide support and connection with Queens Village," he says. "Between Good Samaritan Hospital and University of Cincinnati Medical Center, 80 percent of Black women deliver. So we think by focusing on those two centers, we can really impact the issue with respect to preterm birth and with respect to sleep related deaths."
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