The Butler County partnership to Reduce Infant Mortality (PRIM), held a discussion entitled, “Day of Dialog on Race and Infant Mortality,” on Saturday at the YWCA in Hamilton. It was part of an ongoing effort to to look at why black babies in Butler County and across the country are dying before the age of 1 at twice the rate of white babies.
It’s a troubling and puzzling statistic that local and state health experts say contributes to Ohio’s high infant mortality rate, which is among the worst 10 percent in the nation.
Frances Frazier is a senior associate with the group Everyday Democracy, an organization that has been leading discussions about race for more than 25 years around the United States. Frazier moderated Saturday’s discussion and told the all female crowd, that was quite diverse, that the issue hasn’t been addressed enough.
“This isn’t a Jerry Springer issue, but this is something that we should be working towards creating an action that may change the way people are treated,” Frazier said.
Getting the facts straight
In 2014, Ohio was the worst state in the nation for black infant mortality and fifth worst for white mortality. Butler County is among the 10 worst urban areas in Ohio for infant mortality.
From 2007 to 2014, there were 37,840 births in Butler County and a total of 288 deaths.
Of those total births, 29,537 were non-Hispanic white, and of those, 213 died. That calculates to a 7.2 infant mortality rate. Similarly, there were 3,253 non-Hispanic black babies born in the same time period with 40 infant deaths resulting in a 12.3 rate.
Frazier told the audience that the infant mortality rate is not just something that affects black babies, but the rate is high for white babies as well. “But it is very important to understand that when we talk about how high that rate is for white babies, the fact is that black babies are dying at twice that rate,” she said. “Race is a factor.”
Jennifer Carter, a certified community worker with the Butler County Health Department agreed with Frazier.
“Race is an issue. I see clients who are black getting treated differently. Even when they have the same type of insurance,” Carter said.
One fact that was clarified was the actual definition of the infant mortality rate. Lauren Marsh, director of the Butler County Coalition for healthy, safe and drug-free communities, asked the question and wanted to know what was included under that label.
Jenny Bailer is the nursing director at the Butler County Health Department and co-lead of PRIM, said the infant mortality rate is calculated as the number of babies who died during the first year of life per 1,000 live births.
“There is another category for still birth and another category for fetal deaths,” she explained. “Infant mortality is the measure of a live born baby that dies before his or her first birthday. The most frequent cause of an infant dying is premature birth, so we are concerned about the whole gamut from conception to the first birthday because a lot can happen in that time period. So if we can do something about prematurity, then we can help prevent a lot of infant deaths.”
Potential causes of high infant mortality
Frazier said Everyday Democracy has been contracted by the Ohio Department of Health’s Bureau of Child Support to help support the agency’s Outcomes Initiative — a program put in place to help reduce racial and ethnic disparities in infant mortality.
She explained that research is determining that poverty, discrimination and socioeconomic distress is leading to high infant mortality rates for black babies.
“Researchers are finding out that African American people have very high cortisol rates (stress hormone) — so the stress of being black in a country that is racially oppressive is somehow impacting pregnant women who are African American,” Frazier said.
She also shared that a study was done on women of color from Africa who moved to the United States and had healthy birth rates, but after living here a year — considered one generation — sadly those healthy rates plummeted.
“Their rates became the same as African American women who were already living here,” Frazier said.
Developing a plan
What Everyday Democracy is doing is working with nine urban centers located in Hamilton, Butler, Lucas, Summit, Franklin, Montgomery, Mahoning, Cuyahoga and Stark counties to implement a process called “Dialogue-to-Change.”
Frazier said the program calls for getting a group of diverse people involved in engaging community members to raise awareness of the infant mortality issue and continue to challenge everybody from health care workers to families to make a difference.
It also involves developing a community report card involving: education, employment, criminal justice, leadership, social services, media, health care and public works. Frazier explained that the community group should give each entity in the aforementioned categories a grade ranging from A-F, to make sure everybody is pitching in to help solve the program.
Bailer is also reminding women to use the High Hopes program. It is offered by the Butler County Health Department to help African American women in the area deal with pregnancy issues.
Certified community health workers make scheduled home visits during a woman’s pregnancy and will visit until her child reaches age two, helping with health education and life skills training.
Experts, political push to solve the problem
Jessica Saunders is the director for the Center of Child Health and Wellness at Dayton Children’s Hospital, which was started a year ago to look at what impacts a child’s health outside of the hospital.
She said that Ohio is one of the worst states in the country when it comes to having a high infant mortality rates for all babies.
“For African-American babies, we are absolutely dead last,” she explained. “That is abysmal and should shock everybody and should sound an alarm that we should be doing so much more.”
Saunders said that poverty and the inability to get access to healthy food and good health care are leading factors in the high rate with black babies.
“There are some best practice strategies that some other states and some areas in Ohio are starting to look at and that is helping,” she said. “Prematurity, birth defects and unsafe sleep are three of the big issues that are part of the infant mortality rate, and we are addressing these issues more now.”
Saunders said that Ohio can’t get any worse with its numbers, but there is a silver lining.
“In 2014, our infant mortality rate went down overall, and there is a lot of discussions taking place in health departments and hospitals, but we just need to make sure we are focusing on women and children, especially in the black population,” Saunders said.
Kitty Russ, nurse manager at the Cleveland Clinic Children’s Fairview Hospital, agrees with Saunders. Premature births, lack of access to healthy foods and poverty are factors in the high infant mortality rates with black babies, she said.
She also explained that Ohio has been successfully using the The Pregnancy Risk Assessment Monitoring System (PRAMS), which she said “helps examine maternal behaviors and experiences before, during and after a woman’s pregnancy, and early infancy of her child.”
State Sen. Shannon Jones (R-Springboro), joined Columbus area State Sen. Charleta Tavares, to form a commission that will study ways to fight the Ohio’s high infant mortality rate.
“Senator Tavares and I began planning this Commission years ago, and it is coming to fruition at a critical time,” Jones said. “Ohio is a very sick state, and our unacceptably high infant mortality rate can give us insight into why that is. Infant mortality is not just about babies— it is a reflection of the overall health and wellness of entire communities.”