OUR MOMS, OUR BABIES. The state of maternal and infant health in Cincinnati and Hamilton County

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1 OUR MOMS, OUR BABIES The state of maternal and infant health in and Hamilton County

2 OUR CITY FACES AN INFANT DEATH CRISIS. Over the past five years, 543 babies died in Hamilton County. That s 543 kids who never had a birthday party. 543 children who never went to school. 543 people who never had a chance to grow up. This puts at twice the national average, and gives Hamilton County the tragic distinction of being among the five worst urban communities in our country. This is unacceptable. Infant deaths per 1,000 births What does our infant mortality show us? Hamilton County United States Sources: Ohio Department of Health, Hamilton County Public Health, Centers for Disease Control and Prevention. Data for and Hamilton County is the infant mortality rate. Data for United States is for the year Poor health. A community s infant mortality rate is often seen as a canary in the coal mine. If our most vulnerable citizens are dying at an alarming rate, that indicates poor overall health for the rest of us. Inequality. The prematurity rate in Hamilton County is 69% higher among African Americans. Ohio s African American infants die at more than twice the rate of white infants. That holds true even when factoring in socioeconomic status. Source: Ohio Dept of Health Expense. Premature babies medical costs average more than 12 times those of a full term baby. That means that our community spends more than $80 million a year on preemie care. We collectively bear that cost through increased insurance and Medicaid premiums. Source: March of Dimes

3 Helping our babies begins by helping our mothers. Premature birth is the root of most infant health problems. Solving this crisis begins with helping our mothers carry their babies to full term. And since over half of local pregnancies are unplanned, improving a mother s health during pregnancy relies upon improving women s health in general. We need better women s health. We need better pregnancy health. We need better infant health. Women with pregnancies spaced less than 18 months apart are 368 % more likely to have an infant death Womens Health Pregnancy Year One Women in Hamilton County struggle with higher rates of obesity, STDs, drug abuse, poverty and stress than state and national averages. This means they re more likely to be at risk before pregnancy even begins. Pregnant women in our community are more likely to deal with hypertension, gestational diabetes and preterm birth than their peers. In their first year of life, babies in Hamilton County die in their sleep at three times the national rate. Their mothers are less likely to breastfeed, less likely to receive a postpartum check-up and more likely to suffer from postpartum depression. Women who enter pregancy obese are 48 % more likely to have an infant death Moms who smoke at any point during their pregnancies are 44 % 70% County infant deaths were impacted by preterm birth more likely to have an infant death Sources: Hamilton County Public Health, Maternal and Infant Health Assessment Chartbook ; Health Department, Fetal and Infant Mortality Review

4 We re three steps from making a difference. Cradle is a collective of city leaders united against infant mortality. We launched in 2013 with a bold vision: that every child born in Hamilton County will live to see his or her first birthday. Infant mortality is a complex issue, but it s solvable. We believe our numbers can change. And when they do, our city will change. Here are three ways we can save lives. We call them the 3 S s. Spacing Enough time between pregnancies. Preterm birth is more likely if Mom gets pregnant less than 18 months after giving birth to her previous child. Smoking No tobacco while pregnant. Smoking increases the likelihood of premature birth. 33% County infant deaths were impacted by inadequately spaced pregnancies 15% County infant deaths were impacted by smoking while pregnant Sleep Safer sleep practices. Babies sleep safest when they sleep alone, on their backs and in a crib. 16% County infant deaths were impacted by unsafe sleep Cradle is a partnership between: Hamilton County, The City of, Children s Hospital Medical Center, UC Health, Mercy Health, TriHealth, The Christ Hospital, The United Way of Greater, The Greater Foundation, The Center for Closing the Health Gap, Interact for Health, The UC College of Nursing, The Medical Association, The Greater Health Council, Deskey, The Health Department, Hamilton County Public Health Sources: Health Department, Fetal and Infant Mortality Review

5 What happens now? We work together. Our infant death crisis can only be solved by a city united by individuals, neighborhoods and organizations all running to the aid of our most vulnerable citizens. Our mothers need to know that they and their babies are loved, and see proof through overwhelming support in their own communities. Our medical community needs to work cooperatively toward a better system for women. And we all must be able to communicate simple, actionable steps to improve the outcomes of our own friends and family. How can I help? Your biggest contribution to this fight is to either partner or promote. Partner Join the other organizations and communities in our citywide fight against infant mortality. Contact us at info@cradlecincinnati.org to learn more. Promote Simply share our story with a friend. Let them know about the state of our community when it comes to infant mortality. Share the 3 S s three simple but impactful ways to change our city.

6 Supporting Data Women s Health Pregnancy Health Infant Health LOCAL COMPARISON BEST 5 WORST 5 AFRICAN AMERICAN WHITE 2012 IMPACT LOCAL COMPARISON BEST 5 WORST 5 AFRICAN AMERICAN WHITE 2012 IMPACT LOCAL COMPARISON BEST 5 WORST 5 AFRICAN AMERICAN WHITE 2012 IMPACT Pre-pregnancy Body Mass Index Preterm Birth Rate Breastfeeding Rates upon hospital discharge Underweight (BMI < 18.5) <37 Weeks Obese (BMI 30) Sexually Transmitted Infection Rates Syphilis Gonorrhea Chlamydia <32 Weeks <23 Weeks Late or No Prenatal Care Accessed care in third trimester No care Postpartum Checkup Postpartum Depression Todd Portune Hamilton County Commissioner; Co-chair, Cradle Wendell Young City Councilmember; Co-chair, Cradle Brought to you by: Ryan Adcock Executive Director, Cradle Unintentional Pregnancy Inadequately Spaced Pregnancy Less than 18 months between pregnancies Maternal Smoking Rates Previous Preterm Births among women with previous births Unsafe Sleep Deaths / 1,000 1, / / 1, / 1, Always or usually get social/emotional support among all adults 79.0 (OH) 81.0 (MA) Substance Abuse Rates among all adults Chronic Illness or Co-Morbid Condition Gestational Diabetes Hypertension In partnership with: Smoking Excessive Drinking Illegal Drugs Individuals with Stable Housing among the entire population Renters Vacancy Rate >1 Occupants Per Room Moved in the Past Year (OH) Terms LOCAL: Hamilton County unless otherwise indicated. COMPARISON: State of Ohio unless otherwise indicated. BEST 5 : How the neighborhoods with the best infant mortality rates fared in this category (45230, 45251, 45209, 45218, 45226). WORST 5 : How the neighborhoods with the worst infant mortality rates fared in this category (45219, 45203, 45237, 45229, 45224) IMPACT: % of infant deaths in 2012 that had this associated factor. All numbers are percentages, unless otherwise indicated. African American and White data is shown to reveal inequality. Data Sources 2011 Ohio Department of Health Vital Statistics; Pregnancy Risk Assessment Monitoring System (PRAMS); Behavioral Risk Factor Surveillance System (BRFSS); 2011 Ohio Department of Health Vital Statistics; Fetal and Infant Mortality Review; American Community Survey; 2012 March of Dimes report card Thanks to: Eric Hall, PhD; Data Director, Cradle Jennifer Mooney, PhD, MS; Health Department David Carlson, MPH; Hamilton County Public Health Will Scott; Cradle Maggie Hague; Health Department David White; Project Coordinator, Cradle Design: Craig Dockery Photography: Jonathan Willis Creative Assistance: Jennie Chacon

7 Cradle : a collective of city leaders with the bold vision that every child born in Hamilton County will live to see his or her first birthday. Three ways to save lives Spacing Enough time between pregnancies. Preterm birth is more likely if Mom gets pregnant less than 18 months after giving birth to her previous child. Smoking No tobacco while pregnant. Smoking increases the likelihood of premature birth. Sleep Safer sleep practices. Babies sleep safest when they sleep alone, on their backs and in a crib. cradlecincinnati.org info@cradlecincinnati.org