As Infant Mortality Rate Decreases, Cradle Cincinnati Is Shifting Focus

Apr 25, 2019

Hamilton County is reporting 2018 saw a 50-year low in the number of babies dying before their first birthday. Cradle Cincinnati says there were 92 deaths last year, down from 97 in 2017.

That puts the county's infant mortality rate at 8.6 deaths per 1,000 live births.

A racial breakdown shows white and Hispanic infant mortality rates are at the U.S. averages. While the black infant death rate improved 11%, it remains "more than three times higher than the white rate and 32% worse than the U.S. black average," according to Cradle Cincinnati.

With that in mind, the agency is shifting directions.

"Our strategy now is to focus squarely and unapologetically on black women," says Meredith Shockley-Smith, director of community strategies for Cradle Cincinnati. "The problem here is not with individuals' behaviors, but rather with larger systems that are impacting black families – regardless of income – in disproportionately negative ways."

Cradle Cincinnati is taking a four-pronged approach to address racial disparity in infant mortality. Efforts include:

  • Increasing the number of community health workers who help women handle social needs surrounding pregnancy like transportation, housing, and employment.
  • Expanding group prenatal care is shown to have a positive affect on birth outcomes for black women.
  • Advocating for policy-based solutions at the state and local level.
  • Training health workers, especially those in prenatal care, on how to identify and rectify implicit bias.

Work is already underway to address implicit bias. Cradle Cincinnati last year identified racism as a key factor affecting black maternal and infant health and began implementing strategies.

"This past year we spent time with all of the largest maternity systems in Hamilton County," says Cradle Cincinnati Executive Director Ryan Adcock. "People who are delivering prenatal care throughout Hamilton County came together and said 'Yes, we believe that intentional or otherwise women are leaving our prenatal care practices feeling like they got unequal care and we want to do something about that."

A consulting group created a series of equity training programs for prenatal care practitioners - everyone from doctors to front desk staff - and Adcock says people are signing up, even "normally competing health care practices have set aside that competition and said this is a place we can get better together."

Other initiatives continue, like expanding cohort groups that bring black women together to encourage each other and make sure moms' health care and related needs are being met. The Start Strong program saw huge successes in Avondale and is expanding into 12 zip codes. There's also a community-driven effort called Queens Village, in which black women come together to support one another, especially through pregnancy and motherhood.

Cradle Cincinnati argues the county's high infant mortality rates are a result of a flawed and unequal system, not the parents.

"This racial disparity is not caused by genetics, it's not caused by biology. We don't see it go away even when you take away socioeconomic status," Adcock says. "All of the easy ways in which you might explain away the racial disparity in infant mortality aren't available to us, and what we're left with is social factors.

"We need to think about the experience of being black in America and why is that leading to poorer birth outcomes."

Read the 2019 Cradle Cincinnati Annual report here:

Cradle Cincinnati 2019 Annu... by on Scribd