By William K. Alcorn
The effort to reduce Mahoning County’s disturbing black infant-mortality rate is a marathon, not a sprint.
Mahoning County’s overall infant-mortality rate, among the worst in Ohio and the nation, is improving.
But, local health officials say, reducing the rate that babies die, especially black babies, before their first birthday will take time.
“What we can say,” said Dr. Elena Rossi, neonatologist and associate chairwoman of pediatrics for Akron Children’s Hospital Mahoning Valley in Boardman, “is that Ohio did better in 2014, when the state had the 39th worst overall infant-mortality rate in the nation, compared to 46th overall and 50th among blacks IMR in 2012.”
Infant mortality is defined as the death of a baby before its first birthday. The IMR is the number of babies who die in the first year of life per 1,000 live births.
Most infant deaths occur when babies are born too small and too early (pre-term births are those before 37 weeks gestation), are less than 2,500 grams when they are born with serious birth defects, are victims of sudden infant death syndrome or sudden unexpected infant death syndrome, and when they are affected by maternal complications of pregnancy, or victims of injuries such as suffocation or vehicle accidents, health officials say.
These leading causes of infant mortality together accounted for 77 percent of all infant deaths in Ohio in 2012, according to the Ohio Hospital Association, the last year such statistics were available.
Being culturally competent – understanding the cultures of different ethnic groups and races and how they react and interact – would help understand why there are large disparities in the black infant-mortality rate, and what can be done in the public-health area or elsewhere to improve the IMR, said Leigh Greene, director of the Youngstown Office on Minority Health.
But, there are roadblocks, including the stress from racism.
For instance, people with a criminal background can’t get into proper housing.
“It is hard to concentrate on prenatal care when you are couch-surfing [without a permanent place to live] and trying to feed yourself and your children,” Greene said.
Despite the roadblocks, with the local organizations working together and new programs put in place, Greene is hopeful the black IMR will improve in 2016 and 2017.
She said the IMR actually was worse in 2015 than in 2014.
The black IMR in Mahoning County was 17.7 in 2015 and 10.2 in 2014. This compares with white babies’ IMR of 6.4 in 2014 and 5.2 in 2015, Greene said.
During 2015, several initiatives got underway, including MY (Mahoning Youngstown) Baby’s 1st Infant Mortality Prevention Coalition and the Pathways HUB, Greene said.
Also, earlier this year a dialogue on racism, which produced nine faith-based, community-driven action teams to improve the infant-mortality rate, occurred, she said.
“We are doing wonderful collaborative work with organizations such as the Pathways HUB, MY Baby’s 1st and others. I’m proud we are working together to educate our community toward healthy birth outcomes,” Dr. Rossi said.
“But my message is, while we have improved overall in the state and Mahoning County, there is still significant disparity between the IMRs of whites and blacks,” she added.
“We’ve [Mahoning County] reached the 2020 goals for whites but not for blacks. Racial disparity still exists. We’re still really, really doing horribly improving the black infant-mortality rate,” she said.
In 2014, Ohio, for the first time, met the Healthy People.gov 2020 goal of less than 6 per 1,000 live births for white infants, and for the first time in recent years, the state had fewer than 1,000 deaths overall of infants in their first year of life, so progress is being made.
Erin Bishop, Youngstown City health commissioner and co-leader of MY Baby’s 1st with Patti Sweeney, Mahoning County health commissioner, of MY Baby’s 1st, said: “We are headed in the right direction.”
“We have numerous programs in place and now everyone is working together. And, while we haven’t reduced the IMR to the degree we would like, the rates are gradually going down,” Bishop said.
“We’ve only had this concerted effort to reduce our IMR for three years. We’re in it for the long haul,” she said.
There has been improvement since the beginning of the local effort to reduce infant mortality when Youngstown City and Mahoning County health boards each contributed $20,000 and the Western Reserve Health Foundation $20,000 to make up the $60,000 needed for membership in the Ohio Equity Institute, consisting of nine metropolitan areas, of which Youngstown is one, which investment recently turned into $2.4 million.
Being one of the nine metropolitan areas made MY Baby’s 1st eligible to apply for special funding from the Ohio Department of Medicaid, which the county board of health did.
The result was to bring $2.4 million into the county over two years, Sweeney said.
The money will be used to expand several programs officials believe are making a difference in the county’s IMR, such as expanding the Centering Pregnancy Programs from one to three sites in Mahoning County; expanding the capacity of Resource Mothers and the Ohio Infant Mortality Reduction Initiative by hiring additional certified community health workers who work with pregnant women; and expanding the Pathways HUB in Mahoning County, which provides transportation for women and children engaged in any of the infant-mortality programs to get to medical and other appointments.
“MY Baby’s 1st and other agencies working together give us a better chance of making progress ... but the black infant-mortality rate is still three times that of the whites,” Bishop said.
“We are making progress, but we still have a lot of work to do. If we go at the same pace to achieve parity that we are going now, it would take until 2050. That’s unacceptable,” she added.