Despite improvement, black infant-mortality remains concern

By WILLIAM K. ALCORN

alcorn@vindy.com

YOUNGSTOWN

Area health officials leading the fight to reduce the dismal infant-mortality rate in Youngstown and Mahoning County are encouraged the overall rate of babies dying before their first birthdays was slightly less in Ohio in 2014 compared with 2013.

They are concerned, however, that the black infant-mortality rate has not improved.

“It is twice the overall rate, and that has to be our focus moving forward,” said Dr. Elena Rossi, associate chairwoman of the pediatrics department at Akron Children’s Hospital Mahoning Valley and one of the leaders of the M-Y Baby’s 1st organization.

The M-Y Baby’s 1st, originally known as the Birth Outcome Equity team, has several initiatives to improve the infant-mortality rate, or IMR, in Youngstown and Mahoning County, including safe sleep, centering pregnancy, birth spacing and premature births.

“With state data, we can target at-risk patients in ZIP codes with low income and low education,” Dr. Rossi said.

Infant mortality is defined as the death of a live-born baby before its first birthday. The infant-mortality rate is the number of such deaths per 1,000 live-born births.

According to the Ohio Department of Health, Ohio’s overall IMR is showing signs of improvement.

The black IMR, however, remains twice that of white infants.

The ODH recently reported there was a decline in the overall IMR from 7.4 percent in 2013 to 6.8 percent in 2014.

“While we are encouraged by the trends, there is much work to do, especially when it comes to African-American infants who die at more than twice the rate of white infants. We are optimistic that our recent initiatives will help us accelerate our progress,” said Rick Hodges, ODH director.

“Given the importance of this issue, we sped up the process of collecting and analyzing data to provide the annual infant-mortality report several months earlier than in past years in order to help our many partners who are on the front lines in the fight to save babies’ lives,” he said.

Ohio’s goal is to reach the Healthy People 2020 objective of a 6.0 IMR or lower in every race and ethnic group. Healthy People 2020 is a national collaborative managed by the U.S. Department of Health and Human Services that provides science-based, national objectives for improving the health of Americans.

The number of infant deaths in Ohio declined nearly 6.7 percent from 1,024 in 2013 to 955 in 2014, marking the first time since deaths were registered in Ohio beginning in 1939 that the state had fewer than 1,000 infant deaths in a year.

The three leading causes of infant deaths in Ohio are prematurity/pre-term births, sleep-related deaths and birth defects, the ODH reported.

Improvement in the overall IMR is particularly significant because it came at the beginning of the Ohio Equity Institute initiative, of which M-Y Baby’s 1st is an offshoot, said Patricia Sweeney, commissioner of the Mahoning County District Board of Health.

The first two years of the Ohio Equity Institute involved collection and evaluation of data and developing planning strategies to combat the problem. Implementation did not begin until 2015, Sweeney said.

“We certainly hope the decline in the overall infant mortality rate in Ohio from 7.4 percent in 2013 to 6.8 percent in 2014 is a trend, not an anomaly. Anytime you can save babies lives, I’m encouraged,” Sweeney said.

But, she said, “We really need to work on reducing the black infant-mortality rate.”

Sweeney said the Centering Pregnancy Program, which advocates waiting at least 18 months after giving birth to get pregnant again, is a tremendous support system and education opportunity.

All the data indicates that women who participate in Centering Pregnancy have better birth outcomes, higher birth weights and less prematurity.

Another program, Resource Mothers, connect pregnant and parenting women with resources, such as keeping doctor and Women, Infant and Children appointments, Sweeney said.

She said the Western Reserve Health Foundation has provided funding to help M-Y Baby’s 1st reach out to women in areas that birth and death certificates show have low birth weights and premature births.

The overall number of infant deaths in Mahoning County was 22 in 2013 compared with 15 in 2014, Dr. Rossi said.

“We hope we are having a positive effect on sleep-related deaths, that make up about 15 percent of infant mortality,” Dr. Rossi said. But, she said, prematurity makes up 45 percent of infant deaths. “That’s where we will concentrate,” she said.

Birth spacing is huge, and black women are 20 times more likely to have premature babies if they wait 12 months or less between pregnancies, Dr. Rossi said.

Social support is also crucial in ensuring at-risk women get prenatal care and education about waiting at least 18 months between pregnancies.

“We are just starting to make progress locally, but the Ohio Equity Institute and M-Y Baby’s 1st are putting things in place to help pregnant and parenting mothers get the support they need to have healthy babies so that all our babies can celebrate their first birthdays,” Sweeney said.