Over the years, The Center for Community Solutions, and our partners, have been advocating for the reduction of infant deaths across the state. According to the Ohio State Health Improvement Plan (SHIP), the goal is to decrease infant mortality by six or fewer deaths per 1,000 live births in all racial and ethnic groups by 2028. Is Ohio going in the right direction to reach this goal as we get closer to 2028?
Current statistics on infant mortality
The 2024 preliminary data from the Ohio Department of Children and Youth (DCY) showed that the state’s infant mortality rate (IMR) is 6.5 per 1,000 live births. According to DCY’s latest report on infant deaths, the overall IMR for Ohio in 2023 was 7.1 infant deaths per 1,000 live births. The rates get worse when looking at Cuyahoga County and Cleveland. Preliminary data from the Cuyahoga County Board of Health’s report shows that the overall IMR for Cuyahoga County in 2023 was 8.8 infant deaths per 1,000 live births. The Cleveland Department of Public Health (CDPH) identified the infant mortality trends for the city by gathering data from the Ohio Department of Health’s Bureau of Vital Statistics. The overall IMR in Cleveland, which is also preliminary data, is magnified to 13.6 infant deaths per 1,000 live births in 2023.
Consequently, race disparities persist in infant mortality. The following table presents infant mortality rates based on race and ethnicity in 2023 from state to local areas. At all geographical locations, non-Hispanic Black babies are disproportionally dying at higher rates compared to non-Hispanic white babies.
Infant mortality rates by race and ethnicity, 2023
Redlining and health outcomes
DCY reported that Cuyahoga County has the second highest number of infant deaths (521) between 2019 – 2023 of any county in Ohio. CDPH listed the top neighborhoods with the highest infant mortality rates between 2021 and 2023:
- Lee-Seville
- Kinsman
- Union-Miles Park
- Hough
- Downtown
Besides Downtown, all the neighborhoods are on the east side of Cleveland, which continues to feel the effects of redlining. Redlining is a discriminatory practice which pertains to the denial of services like insurance loans, mortgages, and other financial services to individuals (based on race or ethnicity) who live in specific neighborhoods. The health effects of redlining include — but not limited to — the increased odds of preterm birth, hypertension, diabetes, and early mortality.
Sudden Unexpected Infant Death (SUID) is listed as a major cause of infant deaths in Cuyahoga County and Cleveland.
Leading causes of infant deaths by geographical location
The following presents the leading causes of infant deaths between the three geographical locations.** This is not an exhaustive list:
- Prematurity (Ohio, Cuyahoga County, Cleveland)
- Congenital conditions (Ohio, Cuyahoga County, Cleveland)
- Perinatal infections (Ohio and Cuyahoga County)
- Obstetric conditions (Ohio and Cuyahoga County)
- External causes, including accidental suffocation (Ohio and Cuyahoga County)
- Sudden Unexpected Infant Death (Cuyahoga County and Cleveland)
- Sudden Infant Death Syndrome, also known as SIDS (Ohio)
Across all three geographical locations, prematurity is the leading cause of infant deaths. Prematurity refers to infants being born at less than 37 weeks of gestation. A preterm birth can result in complications such as low birth weight. Sudden Unexpected Infant Death (SUID) is listed as a major cause of infant deaths in Cuyahoga County and Cleveland while Sudden Infant Death Syndrome (a type of SUID) is a significant cause in Ohio.
If you want to learn more about how you can advocate during the state budget, watch our recent webinar.
Solutions to reduce infant deaths
As infant deaths are an important public health issue across our state and especially locally in Northeast Ohio, we must consider policy, community, and systemic solutions. At the policy level, the state government is going through its state budget development for Fiscal Years 2026 and 2027. The House passed its version of the state budget, which includes limiting Medicaid reimbursement for doulas to only six counties with the highest infant deaths. Doulas use interventions to reduce infant mortality rates. There are also funding cuts to Infant Vitality and Help Me Grow, essential community programs that help expectant and other birthing parents learn about how to be healthy for themselves and their babies. The Ohio Senate is now the focus of advocacy to reinstate maternal and infant health programs and restore doula access to Medicaid reimbursement across the state. The Senate plans to release its version of the budget in late May/early June, so now is the time to reach out to them. To find your senator, refer to the Ohio Senate’s website. If you want to learn more about how you can advocate during the state budget, watch our recent webinar.
The Cuyahoga County Board of Health provided some recommendations on how to prevent infant deaths at a community and systems levels. For instance, it’s important to support public awareness and research about the causes, risks, and long-term effects of prematurity. In order to decrease the risk of preterm births, one should educate birthing parents about the significance of interconception care, the warning signs of preterm labor, and the significance of the life course perspective. Another suggestion is to educate staff at birthing and pediatric hospitals about the importance of role modeling safe sleep in the hospital. In return, the staff at birthing and pediatric hospitals can teach parents about safe sleep, as sleep-related deaths are related to infant mortality.
Conclusion
Infant mortality is a societal problem that needs to be reduced throughout our communities. It will take a collective effort to achieve the SHIP’s goal and eventually end infant mortality. Infants will grow to become effective citizens in our society, so their lives should be protected.
*CCBH gathered preliminary data on Cuyahoga County from the Bureau of Vital Statistics, Birth Comprehensive Protected dataset, Mortality Comprehensive Protected dataset.
**Causes of death for Ohio and Cuyahoga was based on 2023 data and from 2018-2023 for Cleveland.
