Reducing Racial Disparities
addressing Extreme Prematurity
Eliminating Sleep-Related Deaths
Summarized below are highlights from 2019. Much collective work has been done to decrease infant deaths in Cuyahoga County, particularly African American infant deaths, and much more will be executed in the coming year. Our thanks to all those who work alongside us to tackle these challenges, achieve our goals and save our babies!
Infant death reductions are being achieved. The data cited below are reflective of data gathered through February 7, 2020, and are provided by the Cuyahoga County Board of Health and the City of Cleveland. (2019 data are preliminary and unaudited)
Infant mortality is being addressed with urgency through 12 active FYC Action Teams. These FYC Action Teams are executing the activities outlined in their respective charters and work plans.
FYC has led and grown a community-wide network of nearly 500 participants and partners, including parents and prospective parents, individuals with a lived experience of infant loss, neighborhood initiatives, faith-based organizations, nonprofits, corporations, philanthropic organizations, health care providers, hospital systems, and government entities.
FYC sponsored, with the YWCA Greater Cleveland, a National Equity Conference in Cleveland on November 8 and 9, 2019. This conference acknowledged the 400-year anniversary of slavery in this country and the specific, urgent action necessary to address structural racism. Conference attendance exceeded 500 participants, with several national experts presenting. As an outcome, efforts to declare racism a public health crisis are underway.
FYC has been active in leading efforts to scale up effective programs serving African American expectant parents and new parents. As a result, the community has increased the number of Home Visiting and birth worker slots and has served 3,600 additional consumers over three years through Ohio Department of Medicaid grants to four highly effective agencies – MomsFirst, Birthing Beautiful Communities, Moms & Babies First, and Nurse Family Partnership. Ninety-eight percent of the additional slots served African American expectant parents and each of these high performing programs had a significantly lower infant mortality rate when compared to Cuyahoga County’s African American expectant parents not served in these programs.
Over the last several years, FYC increased the number of CenteringPregnancy® slots by over 1,300. Eighty percent of the additional slots served African American expectant parents. National data shows that African American expectant parents served in a Centering® program experience a 41 percent reduction in premature births. The FYC Centering Coalition is now one of the largest and most active Centering® systems in the United States. FYC will strive to increase enrollment over the next five years.
Through FYC, an African American parent-led initiative has established a Grief Recovery Institute, building pregnancy and infant loss grief support capacity among African American professionals and paraprofessionals. The initiative hosts an annual infant death remembrance event each October and held the premiere of their film “Toxic: A Black Woman’s Story” on September 25, 2019. Due to overwhelming demand, additional screenings of "Toxic" have been slated for early 2020.
Five additional local cities are working with the Cuyahoga County Board of Health to launch Tobacco21 efforts, a highly effective anti-smoking public policy initiative with proven results. Decreasing smoking rates among expectant parents and new parents, as well as decreasing second and third-hand exposure to smoke, will positively impact the number of infant deaths.
FYC has been able to scale best practice interventions, notably growing the number of Safe Sleep Heroes. Over 1,000 Safe Sleep Heroes have been recruited and trained as a sustainable community engagement effort to reduce preventable sleep-related infant deaths.
Fatherhood and faith-based programs are being integrated throughout home visiting programs, bringing value-add program components that are key to reducing infant deaths.
Through FYC and for the first time, local hospitals’ OB and NICU clinical leaders are meeting to review medical record data and participating in shared learning in order to improve health care services to decrease maternal and infant deaths, specifically mothers and infants of color.
FYC and UH received one of the only system-wide anti-racism infant mortality grants from the Ohio Department of Medicaid (ODM). FYC certified 28 local trainers throughout multiple local systems using a highly effective, evidence-based Cook Ross Workplace Bias curriculum. By the end of 2019, over 1,000 key employees throughout multiple systems will have completed this impactful bias training. This training, along with educational materials developed for health care institutions, is part of ongoing and strategic racial bias training and Human Resource transformation efforts to address systemwide structural racism. FYC is also sponsoring and supporting racial equity training through the Racial Equity Institute.
FYC is working with the Cuyahoga County Metropolitan Housing Authority to secure important housing vouchers for high-risk pregnant women in need of stable housing.
FYC is Primary Applicant to the Ohio Department of Medicaid Healthy Moms and Babies grant opportunity. This opportunity secured $4.8 million for Cuyahoga County programs critical to improving birth outcomes and reducing disparities among the African American Medicaid population. The funds went directly to seven local, highly effective entities to expand nine programs that have a track record of reducing African American infant deaths.
FYC is leading efforts to impact state-wide policy and develop integrated and sustainable funding sources for best practice interventions through an aggressive three-year Community Engagement and Public Policy Strategic Plan, begun in June 2018. FYC is working with Advocacy & Communication Solutions and The Center for Community Solutions to achieve Medicaid billing solutions so programs can have long-term financial sustainability rather than depending on limited grant funds. FYC has demonstrated its ability to advocate and secure critical state funds for local infant mortality efforts targeted at reducing African American infant deaths and will continue this work into the next year.
To target interventions, FYC is identifying opportunities to improve access to and the use of data, with efforts focused on greater access to data reported by programs, analyzing both city and county-level data for end of year 2020 goals, and pursuing the role that managed care organizations could play in providing birth outcome results tied to specific programs.
FYC was one of the first infant mortality collaborations in the state to call out structural racism as a key factor in our local and state high infant death rates. FYC has committed to continuing to apply an equity lens to its work.
FYC is being called upon to present at national conferences, leading the discussion on reducing racial disparities and addressing structural racism, and has presented at the Michigan Maternal-Infant Health Statewide Conference, National Grantmakers in Health Conference and the March of Dimes Prematurity Collaborative Conference, “Equity in Action: Moving from Theory to Practice Training,” in Orlando, Florida. In an effort to allow others to gain from FYC’s collective work, FYC is lending its expertise and technical assistance.
FYC has continued to operate with a lean staffing model dedicated to the success of the collective impact collaboration.
In early 2020, FYC will begin a six-month equity-based strategic planning process and commence execution of the three-year plan in the summer of 2020.
FYC has diversified its revenue stream, with funding from foundations, public sources, Executive Committee members and individual donors.
FYC continues its effective and impactful relationship with Case Western Reserve University School of Medicine, which houses FYC and provides fiscal oversight and significant in-kind support for its operations.
There is urgency and action in our work. We have noted progress in reducing infant deaths within each race but the needle is moving too slowly. We continue to see numbers fluctuate, and acceleration needs to occur on all levels. We have the right road map and we must continue to work strategically and collectively in leading both system changes and scaling effective programs for African American parents and expectant parents to achieve our goals, save our babies and eliminate racial inequities. Our goal is to have no racial inequities between African American and Caucasian babies by 2025. We appreciate all your efforts to ensure continued progress.
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