Ohio’s Infant Mortality Problem: Real Progress Begins with Listening
New Report Features Voices of Women, Community Leaders
The fight against Ohio’s unacceptably high and inequitable rates of infant mortality isn’t new — it has been in high gear at least since 2014, when the General Assembly created a state commission to address it. And unfortunately, it isn’t over: In 2022, 7.1 babies out of every 1,000 live births in Ohio died before their first birthdays.
That’s an improvement over the 2012 rate of 7.6, which put Ohio in 45th place among the states, but progress has been slow and fitful, with actual increases in some years. And most distressingly, the inequity has grown even worse. In 2022, infant mortality for Black babies was 13.4 per 1,000 — well more than double the 5.7 rate for white babies.
For Groundwork Ohio, created in 2004 to advocate for the needs of children from birth to age 5, this issue is central to our work. And it’s equally important to CareSource as part of our commitment to improving the health and well-being of the communities we serve.
That’s why we are very excited to share our newest collaboration. “Threads of Hope: Community Voices Stitching Together Solutions for Healthier Beginnings” isn’t just another description of the problem and potential solutions. While it unquestionably is supported by quantitative data, the report’s greatest power is in the voices of real people — community leaders working to reduce infant mortality and, most important, the women who are living with the challenges that contribute to tragic outcomes.
If there’s anything we’ve learned about population health work, it is that success depends on including the people you hope to serve in the solutions you’re crafting. In the case of infant mortality, anyone who hopes to make a difference has to listen to the lived experience of women — especially Black women, given Ohio’s terribly disproportionate numbers. The data-gathering for this report included interviews with 20 community leaders but also 86 CareSource members, mainly Black women. More than a third lived in ZIP codes with high rates of infant mortality.
Their words form the heart of this report. We believe that, if policymakers truly take them in, their thinking will be changed. Most people who work in and around the Statehouse are not experiencing food insecurity, lack of transportation, unsafe housing, or feeling unseen and unheard because of their socioeconomic status — let alone the tragedy of losing a child due to a cause that could have been prevented. The women we spoke to are living through these challenges. If we want to help them, we need to listen to them.
Indeed, listening to patients, providers and community groups has been the basis for many of the improvements we’ve supported in recent years. For example, in prior community outreach we heard loud and clear that women valued the support of a doula during childbirth, and that led eventually to doula coverage through Medicaid. But the conversation didn’t end there; after that coverage was implemented, we heard about challenges, such as delivery room conflicts between doulas and medical staff and the need for more racial diversity among doulas, and we’re working to address those.
Many of our respondents were from Montgomery County along with much of the report’s new data, in part because Montgomery has higher rates of infant and maternal mortality than the state as a whole. But we’re confident that what we learn from it can be applied to infant-mortality work anywhere.
The report includes a short list of policy priorities, but they come down to three foundational ideas.
- Listen to Black women and learn from their lived experience.
- Address structural barriers to good care for women and babies in marginalized groups.
- Recognize that hospitals, providers and managed care organizations must play a critical role in systemic change.
We hope anyone who cares about healthy moms and babies in Ohio will take a look at this report. Even if you’re not a medical professional or a policymaker, you’ll be moved by these very human stories of people who, like all of us, just want the best for their children. Ultimately, you’ll come away understanding more about this heartrending problem and things we can all do to help solve it.
