Cincinnati's annual infant mortality report indicates Hamilton County rates continue to improve, but still remain high.
Cradle Cincinnati's 2018 report, released Thursday, finds 97 babies died in 2017 before their first birthdays. The agency says the numbers have been improving over the past five years, though the improvement shows signs of leveling off.
Executive Director Ryan Adcock is happy to say Hamilton County is improving more rapidly than other big Ohio counties. However, he says, "from 2016 to 2017, we only had one fewer baby die. So, we're still moving in the right direction, but not at that encouraging pace that we've had in the past. What we really want to see is a much more rapid pace, a more equitable pace."
According to the numbers, Hamilton County's rate of nine deaths per 1,000 live births remains above the national average of 5.9. Sleep-related deaths remain low at 12 per year. Cradle Cincinnati reports Hamilton County's average remains below its historical average for the fifth year in a row.
"We don't believe by any stretch of the imagination that this 15 percent improvement we've seen is good nearly enough," Adcock says. "In 2011 we were the second worst county in the entire country for infant mortality. Now, we're somewhere near about 25th, and that's much better than second but it's not nearly where we want to be."
The number of women smoking while pregnant is also down, and access to care is improving, both factors that increase a baby's odds at a healthy start. "More women than ever before began prenatal care during their first trimester," says Cradle Cincinnati in a statement.
Success In Avondale
Cincinnati's Avondale neighborhood is seeing dramatic improvement in reducing extreme preterm birth, that is babies born before the end of the second trimester. Cradle Cincinnati says the neighborhood hasn't had an extreme preterm birth in three years, cutting its rate of infant death more than 50 percent.
The agency credits the "Start Strong" partnership between families, Cincinnati Children's, UC Health, TriHealth and Every Child Succeeds. Bethesda's grantmaking wing, bi3, provided more than $3 million in funding for the three-year initiative.
The Bethesda organization says the group started by listening to women and families in Avondale in order to understand prenatal care barriers and other issues. They found people often fell through the cracks because the healthcare system was functioning as a bunch of separate parts, rather than a cohesive unit. They then developed and refined strategies based on placing mothers at the center of the care cycle.
"They made sure every mom got a community health worker and every mom got a nurse case manager to help solve not just her medical needs but her social needs," Adcock explains. "If mom needed housing, if mom needed help furthering her education, if mom needed help getting a job, those community health workers and nurse case managers are really there to help support that kind of change in mom's life. We found that to be incredibly valuable."
They also started having monthly community dinners led by Avondale moms and attended by community members and healthcare providers. Adcock says everyone came as "regular people," learning about each other and breaking down trust barriers that have traditionally been been problematic.
Given the program's success, it's being expanded to North College Hill and Winton Hills. The Ohio Department of Health is contributing an $850,000 grant, announced Thursday, to bolster the new efforts.
Launching A New Strategy
Cradle Cincinnati is preparing to introduce a new strategy for combating infant mortality. The agency says it plans to roll out the program in June. "In addition to continuing to focus on key drivers of infant death like spacing, smoking and sleep, this new plan will add new emphasis on more complex factors influencing our high rate of extreme preterm birth," a statement says.
Adcock says the plan includes branching out into new areas of focus like addressing racial bias in the community, reducing stress during pregnancy through social supports, reducing unexpected pregnancies, and broadening strategies to include a stronger push around public policy and research.
Cradle Cincinnati's full 2018 report is below.