Dead last

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If you are a black child born in Ohio, you have the worst chance of surviving until your first birthday of any state in the nation.

The statistics are so grim, in fact, that Erin Bishop, acting health commissioner of the Youngstown Board of Health, noted “Our numbers are similar to those of a Third World country.”

As of 2012, the latest statistics available, Ohio had the worst infant mortality rate, or IMR, in the United States — 50th out of 50 — for black babies who die before they are a year old, according to the National Center for Health Statistics.

Nationally, the overall mortality rate for all babies that die in the first 12 months of their lives is 6.05 per 1,000 births, compared with 7.7 per 1,000 births overall in Ohio, which ranks the state 47 out of 50 in that category.

The disparity between the rate for black and white babies in Ohio is more startling, however, local health officials say.

The death rate for black infants in the state in 2012 was nearly 14 per 1,000 births compared with 6.4 per 1,000 white births, said Dr. Elena Rossi, neonatologist and associate chairwoman of pediatrics at Akron Children’s Hospital Mahoning Valley in Boardman.

In Mahoning County, the disparity between the black and white IMR is even wider

than in the rest of the state. As Patricia Sweeney, commissioner of the Mahoning County Health District, put it “The outcomes are abysmal.”

The white mortality rate was 6 per 1,000 births compared with 23.6 per 1,000 black births in Mahoning County, where the overall mortality rate was 10.8 per 1,000 births. The black mortality rate is up after averaging 16.74 per 1,000 births between 2008 and 2012, Dr. Rossi said.

“What’s facing us is that the rest of the country is improving, and we are getting worse,” Dr. Rossi said.

According to Ohio Department of Health, Ohio’s overall IMR has remained stagnant or gotten worse for more than a decade, while the U.S. overall IMR declined 12 percent from 2005 through 2011.

“Clearly, this is a wake-up call telling us that we need to increase our energy and efforts to direct resources to reduce the infant mortality rate locally and statewide,” Dr. Rossi said.

The first steps for local officials is gathering hard data to identify the causes and set priorities and then apply solutions.

Poverty and the lack of social support (a place to live, healthy food, etc.) play major roles in the worsening infant mortality rate among blacks and whites, but the largest problem is that too many premature babies are being born, health officials said.

“It follows, that the more severely at-risk premature babies that are born, the more infant deaths there will be,” Dr. Rossi said.

Using data, the Mahoning-Youngstown Birth Outcome Equity Team, co-chaired by Sweeney and Bishop, has identified and prioritized areas to improve the overall infant mortality rate.

Bishop also is a member of the Ohio Institute for Equity in Birth Outcomes Leadership Team representing all the Ohio Equity Institute Teams.

The Birth Outcome Equity Team — consisting of public and medical health officials, community leaders, representatives of Women Infant and Children and Mahoning County Family and Children First Council — and other groups and individuals are developing a plan to reduce the disparity between white and black infant mortality rates in Mahoning County.

Local health officials said data reveal not just one cause for Ohio’s and Mahoning County’s high rates.

As a result, they have identified several major areas in which they believe progress can be made through education and medical practices.

On average, three babies die a week in Ohio from sleeping issues, and two of these deaths are potentially preventable, Dr. Rossi said.

Parents need to ensure that babies have a safe sleep environment in a crib and are not in a more-dangerous environment such as a parent’s bed.

Also, women living in poverty and with low education are experiencing poorer birth outcomes than people with more resources, said Sweeney, who noted that a group of 12 to 15 at-risk women who are entering pregnancy is being formed so that the women can go through prenatal care together.

They will be a support system for each other, she said.

“I feel the need to react ... to respond ... to educate and get more people involved. Some of the high IMR is preventable. Fiftieth worst out of 50 states is terrible for black infant mortality rates,” Dr. Rossi said.

“It’s going to be tough to reverse the trend, but we can make improvements. We’re in this for the long haul,” the doctor said.

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