Ohio Infant Mortality Continues to Decline, Gains by Race Remain Uneven

Feb 26, 2020
Originally published on March 7, 2020 1:38 pm

Ohio’s infant mortality rate continued its slow but steady decline in 2018, driven largely by falling death rates for white babies. The rate of infant death in Ohio’s black community, however, remains stubbornly high.

In Ohio, 938 infants died before reaching a first birthday in 2018, down from 982 the year before. The state’s rate of infant death, calculated by the number of deaths among live-born babies per 1,000 births, was 6.9 in 2018. The rate has fallen by a little more than 1 percent a year for the past decade.

The disparity in the rate of infant deaths by race continues to be high, however, and the state still lags behind the national average in overall infant deaths, which is considered a basic indication of the health of a community.

For white babies in the state, the picture is one of continued improvement. From 2009 to 2018, the white infant mortality rate in Ohio has fallen by 2.4 percent overall. The 2018 white infant mortality rate for the state, at 5.4, is below the national average.

Despite a drop in black infant deaths from 2017 to 2018, the number of infant deaths and the overall infant mortality rate among black babies, in contrast, has not significantly changed over the past decade. The rate of black infant deaths remains 2 1/2 to 3 times higher than the rate for white babies.

“I think we’re making progress,” said Alicia Leatherman, program administrator for home visiting and maternal and infant wellness at the Ohio Department of Health (ODH), referring to the drop in black infant deaths in 2018. But, she added, the optimism is “cautious” because “one year doesn’t make a trend.”

Infant mortality statistics are typically released in the fall, and lag more than a year behind due to the time it takes to complete death investigations and compile such data. There was an extra delay in the release of the 2018 infant mortality data because the health department (under new leadership since Gov. Mike DeWine took office in 2019) wanted to look more deeply into the performance of the counties where the majority of both births and deaths of black babies occur to gauge the impact of the state’s investment.

Cuyahoga County, which had the second highest infant mortality rate of large Ohio counties in 2018, behind Hamilton County, is one of these. First Year Cleveland, the city-county infant mortality initiative, today (Tuesday) released its 2019 data which showed a continued drop in infant deaths here, with the infant mortality rate falling from 8.65 in 2018 to 8.48 last year.

Bernadette Kerrigan, executive director of FYC, said that 2018 is “now in the rearview mirror" and the group is focused not on reducing black infant mortality for a single year, but instead on addressing the implicit bias and racism in all of the county systems that serve, house and care for black women to effect long-term change.

The leading causes of infant death in Ohio remain conditions related to prematurity and preterm births, birth defects, external injuries (including accidental suffocation in bed) and Sudden Infant Death Syndrome (SIDS), in that order.

There were at least 140 sleep-related deaths in Ohio in 2018. Of these, more than half were black babies, more than half involved bedsharing, and almost 80 percent of these deaths overall occurred in a non-safe sleep environment.

ODH this year also broke down more fully the characteristics of the infants that died too early and too small in 2018, a perennial problem in the state and the rest of the country, Leatherman said.

Neonatal deaths, occurring in the first month of life, accounted for about two-thirds of infant deaths in Ohio in 2018, a figure which has remained largely steady in recent years. These deaths are closely related to prematurity: Although only 0.3% of infants were born at less than 24 weeks gestation (full term is at least 37 weeks), these births accounted for about one-third of all infant deaths in 2018, according to the state report.

Most of the infants who died in Ohio in 2018 were born too early and too small:

  • Almost half were born at less than 3 pounds, 5 ounces, considered very low birth weight;
  • 44% were born before 28 weeks gestation;
  • Of the babies who died, 12% died in the first hour of life, and 28% more died in the first day of life;
  • Almost one-third of the babies who died were born before 24 weeks gestation, the cutoff before which a baby is unlikely to survive.

The state report did reveal a few glimmers of hope:

  • There were fewer premature births in the black population in 2018 compared to the year before, especially in babies born prior to 23 weeks gestation. The black neonatal mortality rate was 11.3 in 2017 and 8.5 in 2018.
  • After a five-year increase, the black infant mortality rate went from 15.6 per 1,000 live births in 2017 to 13.9 in 2018. The change did not reach statistical significance when looked at over a ten-year period, however.
  • Fewer mothers smoked in the first trimester of pregnancy in 2018 than 2017, and more mothers received prenatal care in the first trimester.

Leatherman said the improvements in preterm infant deaths in the black community makes the department “hopeful that the disparity gap may soon begin to diminish."

Overall, the U.S. has seen a slow but steady decline in infant mortality for decades, falling from about 8 deaths per 1,000 in the mid-1990′s to less than 6 in 2017, the most recent data available. The American rate is still far above other developed countries, however.

Editor's note: This story is from reporter Brie Zeltner at The Plain Dealer and cleveland.com. It is part of a reporting collaborative funded through an Informed Communities grant from the Cleveland Foundation, Akron Community Foundation, Knight Foundation and The Center for Community Solutions. WKSU is partnering with The Plain Dealer and Spectrum News 1 Ohio to produce content on this topic.

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