National Minority Health Month, an effort to advance health equity across the country on behalf of all racial and ethnic minorities, is held in April of each year. Now that the month has come to a close and we think about what this initiative embodies, we can’t help but note statistics that support the racial inequities that lead to black infant mortality rates being three times that of white babies, or black mothers dying at three to four times the rate of white mothers. And we can’t help but note that these disparities aren’t based on the behaviors of African Americans but on the systems themselves. Even relatively well-off, educated black women die at higher rates than whites.
There is agreement among many social scientists and medical researchers that the problem isn’t race, it’s racism. The social inequities are many – inadequate access to healthy food, safe schools and good neighborhoods; the unconscious biases that are unfortunately embedded in our medical systems which affect quality of care; and the chronic stress black women face because of the discrimination they experience on a near-daily basis.
Fortunately, working together from all parties, First Year Cleveland has made tremendous progress in addressing these disparities. By focusing on our priority areas, establishing aggressive goals and attracting hundreds of volunteers intent on affecting change throughout Cuyahoga County, we have accomplished a great deal in only three years:
PRIORITY AREA: REDUCE RACIAL DISPARITIES: By the end of 2020 our community will go from the 2017 baseline of African American to Caucasian infant death disparity rate of 6.7 and reduce it by half by 2020. Our community is striving with urgency that there be no racial disparities in infant deaths by 2025.
Progress through December 2018: Causes of racial disparity include structural racism, the environment of the mother, and long-term stress affecting the mother. In 2017, Cuyahoga County’s infant mortality rate (IMR) for white babies was 2.4 compared to 16.1 for black babies, representing a racial inequity of 6.7. FYC is pleased to report that in 2018, the black to white inequity had declined to 4.0, demonstrating a significant improvement. FYC plans to further reduce this inequity to 3.35 by the end of 2020, and eliminate the racial disparity gap by 2025.
PRIORITY AREA: ADDRESS EXTREME PREMATURITY: By the end of 2020 our community will go from a 14.9 percent preterm birth rate (2015) to the CDC goal of 6.0 IMR by the end of 2020, and further reduce this rate to 5.0 by the end of 2025.
Progress through December 2018: The majority of infant deaths occur in babies born at less than 28 weeks. These are cases of extreme prematurity. For more than two decades, extreme prematurity has been the largest contributing factor to infant mortality in Cuyahoga County. By addressing the social determinants of health and health disparities, FYC is pleased to report that since 2015 the rate of preterm births has decreased from 14.9 percent of all births to a rate of 11.4 percent preterm births in 2018. This represents a decrease in premature births by more than 300 babies in 2017 and 2018.
PRIORITY AREA: ELIMINATE SLEEP-RELATED INFANT DEATHS: By the end of 2020 our community will go from an annual kindergarten class size of sleep related preventable deaths to less than a handful.
Progress through December 2018: Sleep-related deaths are the second leading cause of infant deaths. In 2015, 27 babies died from preventable sleep-related causes in Cuyahoga County. In 2017 this number dropped to 13. These deaths can be attributed to accidental suffocation, sudden infant death syndrome (SIDS), and sudden unexplained infant death syndrome (SUIDS). By the end of 2020, FYC’s goal is to have less than five infant sleep related deaths per year.
We are doing great work and our efforts are proving to be effective, but we mustn’t slow down. We must move forward aggressively if we are to reach our stated goals. If you or someone you know would like to be part of the solution and participate on one of our action teams, please drop us a note, indicating which priority area you are most interested in helping with. And for those of you already engaged in this important work, we thank you.