One of the most troubling realities in our community is that our infant mortality rate – the rate of babies who do not live to their first birthday – is significantly higher than the national average. In Cuyahoga County, nearly nine babies out of every 1,000 live births die, compared to a national infant mortality rate of just under six. In 2016, 128 babies in Cuyahoga County did not make it to their first birthday. Still more troubling is that African-American and Latino babies die at even higher rates. In Ohio, the infant mortality rate for black babies is 15.2- about two and a half times higher than the rate among white babies.
In Cuyahoga County, nearly nine babies out of every 1,000 live births die, compared to a national infant mortality rate of just under six.
The causes of infant mortality are complex (you can read more about birth outcomes and risk factors for infant mortality here), but we know that infants who are born preterm (less than 37 weeks), and with low birth weight (under 5.5 pounds), are at higher risk of death. Previous research by my colleague Joe Ahern found that being African-American or Latino significantly increased the odds of prematurity and low birth weight, even when other factors, such as education, were held constant.Cities in Cuyahoga County with higher populations of black residents seem to have higher rates of prematurity and low birth rates. Read our analysis here Click To Tweet
As I was analyzing the data in our newly released City Fact Sheets, I began to notice a trend. Cities with higher populations of black residents seemed to have higher rates of prematurity and low birth weights. Based on what we already know about infant mortality, and how race is a strong predictor of birth outcomes, this wasn’t a big surprise. It doesn’t make the data any less appalling, however.
In cities in Cuyahoga County, there is a statistically significant correlation between the proportion of the population that is African-American and poor birth outcomes. In the following charts, each dot represents a city in Cuyahoga County, and the blue dotted trend lines reveal the positive relationship between the percent of the population who are African-American and the adverse birth outcomes. In cities with higher concentrations of African-American residents, there is a higher likelihood that babies will be born preterm (r=.787, p<.01).
Likewise, in cities with higher concentrations of African-American residents, there is a higher likelihood that babies will be born with low birth weights (r=.881, p<.01).
Why do racial disparities in birth outcomes persist? Higher poverty rates and lower educational attainment among minorities only explain part of the problem. There is growing acknowledgement in the research that stress from experiencing racism can lead to adverse birth outcomes, infant mortality, and maternal mortality. There is also research that shows that minorities are likely to receive lower quality health care than white people throughout their lives, and, are less likely to have access to care than white people. These data points from our city fact sheets confirm that these racial disparities are evident in our own community. It will take cross-sector collaboration and a lot of hard work to achieve health equity for people of every race and ethnicity, living in every city in our county.