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Implementing evidence-based programs in Mahoning-Youngstown
YOUNGSTOWN
Local public-health leaders returned from the Ohio Infant Mortality Summit late last year encouraged that progress can be made here and across the state to improve birth outcomes that are among the worst in the nation.
But the task is daunting, said Erin Bishop and Patricia Sweeney, commissioners of the Youngstown and Mahoning County health departments, respectively, both of whom attended the summit.
According to the National Center for Health Statistics, as of 2012, the latest statistics available, Ohio had the worst infant-mortality rate for black babies who die before age 1 of any state in the nation; and the state’s ranking for all births was 48th among the 50 states.
In 2012, 1,047 Ohio babies died before their first birthday, prompting Bishop to say that Ohio’s numbers are “similar to those of a Third World country.”
Some 1,700 to 1,800 health-care personnel from around the state, including several from Youngstown City and Mahoning County, attended the Infant Mortality Summit last month in Columbus, the theme of which was “Step Up to Catch Up.”
The Youngstown-Mahoning County area is one of nine major urban areas in the state in which the infant-mortality rate is the worst.
In Mahoning County, the disparity between the black and white infant-mortality rate was wider than the rest of the state in 2012.
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.
Bishop and Sweeney are co-chairwomen of the Mahoning-Youngstown Birth Outcome Equity Team, which is identifying and prioritizing ways in which to reduce the disparity between white and black infant-mortality rates and improve the overall infant-mortality rate.
“I feel confident we are getting it done,” said Bishop, who is a member of the Ohio Institute for Equity in Birth Outcomes Leadership Team which represents the nine Ohio Equity Institute Teams.
The Mahoning-Youngstown Birth Outcome Equity Team consists 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.
Among the topics discussed at the summit were peer support groups for mothers, birth spacing and the use of progesterone, which gives mothers who previously have had pre-term babies a better chance of carrying the next child full-term.
Pre-term babies have low birth weight and are not fully developed, which can lead to poor, and sometimes long-term, health outcomes, Sweeney said.
When the time between having a baby is 18 months or greater, the health outcomes are better, she said.
The root problem is not access to health care after a baby is born, they said.
It is the poor health of mothers coming into the pregnancy caused by the social determinants that lead to poor health, Sweeney said.
Those determinants include education, which could lead to a better job and less poverty; access to healthy food; a safe environment; behavior such as the use of alcohol, tobacco and illegal drugs; and obesity, which can lead to diabetes and high blood pressure, she said.
“It’s not just about infant mortality. We have to factor improving health into everything we do from better education to having safe neighborhoods that encourage exercise,” Sweeney said. “But that is not happening because of the inequities of social determinants of health.”
“I am confident we are making progress,” Bishop said. “We are getting programs that are evidence-based and have worked elsewhere. I think we can do it. ... We have to do it.”