Infant mortality is a serious public health issue in the United States and in Ohio. The United States ranked #32 in infant mortality rates in 2010 and Ohio is ranked #45 among the states. In Cuyahoga County 121 infants died before their first birthday in 2014. More importantly, minority infants are more than twice as likely to die in Cuyahoga County.
On September 29, 2016, the Schubert Center kicked off their 2016-2017 Conversation Series, The Impact of Inequalities on Childhood by co-sponsoring pediatric grand rounds at the UH Rainbow Babies and Children’s Hospital on the topic of infant mortality. Andrea Tremblath, Assistant Professor of Pediatrics at the Center for Child Health and Policy at Rainbow, gave the keynote lecture titled, “Infant Mortality in Social Contexts: Cuyahoga County and Beyond” where she discussed the urgent need to address the high infant mortality rates and disparities in infant mortality rates in Cuyahoga County and Ohio. In Ohio, the infant mortality rate for African American infants is 2.6 times greater than for white children and 2.5 times greater in Cuyahoga County. Dr. Tremblath stressed the need to look to the social determinants of health to understand how to better address these disparities. The social determinants of health refer to non-medical factors that influence health such as socioeconomic status, education, and environment, and racism and discrimination.
Dr. Tremblath was joined by discussants Angela Newman-White, Dr. David Hackney, and Mistie Winfield Hughes to talk about current programs and policies aimed at addressing infant mortality in Cuyahoga County. Angela Newman-White from the Cuyahoga County Board of Health discussed the Child and Family Health Services Program which helps pregnant women and children stay healthy. It also collects health related data in Cuyahoga County to help create programs to improve healthy behaviors and access to care. Dr. David Hackney, director of the Maternal-Fetal Medicine division at UH MacDonald Women’s Hospital discussed the progesterone project. Providing progesterone to pregnant women with prior preterm births has been shown to significantly reduce future preterm births, which is one of the causes of infant mortality. Mistie Winfield Hughes, Co-Chair of the MacDonald and Rainbow Maternal/Infant Mortality Task Force, discussed the CenteringPregnancy program. This is an evidence-based program that enables midwives to provide women with pregnancy and birth-related information in a group setting. Expectant mothers learn together and can support one another throughout their pregnancies. Studies show that the centering pregnancy model leads to a decrease in preterm birth rates, low birth weight and increased knowledge and satisfaction with care.
The talk came one day after the Ohio Senate passed Senate Bill 332, which aims to decrease the state’s high infant mortality rate. The bill aims to improve data access and reporting and to make sure that providers are using evidence-based practices. The bill also attempts to address the social determinants of health in Ohio by creating a community group to review state policies and programs.