Racial Disparities in Infant Mortality Focus of ‘Toxic: A Black Woman’s Story’

Last week, First Year Cleveland through their Pregnancy And Infant Loss Initiative (PAIL), debuted a short film that tells the story of infant loss from a black women’s perspective. As the film website explains, the film invites the viewer to “Follow Nina in this day-in-the-life drama, and see the world through the eyes of a successful black woman who must navigate an unjust world while trying to protect the world she has created for herself and her family.” Funded by First Year Cleveland, the film was developed in partnership with the City of Cleveland’s Healthy Cleveland Healthy Neighborhood Committee and PAIL.

The film brings attention to racial disparities in infant loss

The film debuted at the Natural History Museum on September 25 to a sold-out crowd, and was well received by the more than 400 people who attended. The showing was followed by a panel in which the filmmakers and local experts discussed the reasons for making it, the issues addressed and a call to action. The film brings attention to racial disparities in infant loss, a topic that our Kate Warren addressed in both an infographic series on racial disparities in Cleveland and follow up blog post.

This problem is not unique to Cleveland. Across the state, many counties have racial disparities in infant loss with Black babies dying at a higher rate than white babies. Black babies also have higher rates of low birth weight and prematurity. According to data provided by County Health Rankings, 12 counties have notable disparities between the rate of death among Black and white children under one year of age. The highest disparity between 2011-2017 occurred in Mahoning County, which includes Youngstown, where there were 19 deaths per 1,000 live births among Black babies compared to 5 deaths per 1,000 live births for white babies.

Black babies in the State of Ohio also have a higher rate of low birth weight (below 5.5 lbs) and preterm birth (before 37 weeks) than white babies. This disparity remains when controlling for income and education. A college educated Black women of moderate to high income has a higher likelihood of experiencing infant loss than a white woman with less than a high school education; Community Solutions has written about this reality here and here. A mother’s poverty and lack of education is not the root cause of racial disparities in infant mortality. Rather, it is the structural racism that exists in our community which increases the level of maternal stress for Black expectant mothers and reduces their access to the same level of health care enjoyed by their non-Black counterparts. Studies have demonstrated that Black women of all income levels have the highest allostatic load scores. Allostatic load refers to the long-term effects of continued exposure to chronic stress on the body.

Twelve counties have notable disparities between the rate of death among Black and white children under one year of age

Fortunately, many counties and the major urban centers within those counties have recognized the need and have mobilized the community to address the issue of infant loss and racial disparities. This has been accomplished through cross-sector collaborative groups and in selecting infant mortality as a health priority in county health improvement plans. Each program or initiative is led locally and has developed strategies tailored to their communities. Details for programs in various counties can be found by clicking on the program name in the table below. Common strategies include promoting long acting reversible contraceptive, birth spacing, Centering Pregnancy, empowering moms, safe sleep, Baby & Me tobacco programs, pathways hubs, WIC and initiatives to reduce racial disparities by reducing maternal stress. While data is still being collected and analyzed for many of these newer initiatives, many communities have reported a decline in infant deaths and as well as a decline in disparate outcomes.

CountyProgram NameCountyProgram Name
AllenMoms & Babies FirstLucasHealthy Lucas County
ButlerThe Butler County Partnership to Reduce Infant MortalityMahoningMy Babies 1st Mahoning Youngstown Infant Mortality Coalition
CuyahogaFirst Year ClevelandMontgomeryEveryone Reach One Dayton & Montgomery County Infant Mortality Task Force
Franklin Celebrate OneStarkStark County THRIVE
HamiltonCradle CincinnatiSummitFull Term First Birthday

The film Toxic brings further attention to these issues that many communities throughout the state face. Following the success of the premiere, many individuals and organizations have inquired about showing the film to various interested parties. In response to this outpouring of interest, First Year Cleveland is in the process of developing a distribution plan for Toxic with an accompanying discussion guide. In the next few months, First Year Cleveland will unveil a process for community members, nonprofit organizations and educational institutions to purchase the film and discussion guide to use as an educational tool. To learn more about the film and the work of First Year Cleveland visit www.firstyearcleveland.org  www.pailconnect.org www.toxicshortfilm.com.