Last October, The Center for Community Solutions released fact sheets on the Status of Women for each of Ohio’s 88 counties. The fact sheets include a cross section of health, economic, civic and education indicators. Modeled after the Institute for Women’s Policy Research’s national report on the Status of Women, they provide insight on how Ohio women fare at the county level. This data brings attention to where additional leadership, planning and/or resources are needed to improve conditions that impact women and their families.
In the fact sheets, we included the following health indicators:
- Age-adjusted chronic disease death rate
- Access to a Community Health Center
- Insurance status and type
- Disability
- Preterm births
- Teen births
- Late-stage cervical cancer diagnosis
Other health-related indicators we pursued were behavioral health, maternal mortality, family planning access and domestic violence. Since the release, we have received more data on family planning access, interpregnancy interval, and here we will report on maternal mortality by county.
For the last three years Community Solutions has advocated for increased awareness of maternal mortality and severe maternal morbidity in Ohio.
For the last three years Community Solutions has advocated for increased awareness of maternal mortality and severe maternal morbidity in Ohio. This includes a priority on the frequency and transparency of maternal mortality and morbidity data reporting in the state. The organization prioritized maternal and infant health in its 2016 strategic plan and recognized that healthy infants require healthy and well cared for mothers. While Ohio has led the country in developing processes to investigate maternal deaths, there were delays in state data collection and reporting which challenged the tracking, understanding of, and response to trends.
In November, the Ohio Department of Health (ODH) released the first report in several years on maternal mortality. The report covered maternal deaths that occurred from 2008 through 2016.
The report showed racial disparities persist in maternal mortality – specifically in pregnancy-related deaths in Ohio.[1] (For a full description on data-specific definitions see our 2018 primer.) Across this nine-year span, 109 (59 percent) pregnancy-related deaths occurred among white women, 63 (34 percent) among Black women, six (3 percent) among Hispanic women, and eight (4 percent) among women of other races.
Across this nine-year span, 109 (59 percent) pregnancy-related deaths occurred among white women, 63 (34 percent) among Black women, six (3 percent) among Hispanic women, and eight (4 percent) among women of other races.
At the county level, only 11 counties reported no pregnancy-associated deaths or pregnancy-related deaths during the nine-year reporting period.
The pregnancy-associated mortality rate, per 100,000 live births in each county, was calculated by the state for the 12 counties that reported more than 10 pregnancy-associated deaths. The state rate is 48.2 per 100,000 live births over the nine-year period. Butler (57.5), Clark (88.3), Lorain (52), Mahoning (77.7), Montgomery (78.7), Summit (52.4) and Trumbull (77.6) counties all exceeded the state rate. The state rate was stable until 2015 and 2016 when unintentional injury, in this case overdose, caused a tripling in the number of pregnancy-associated deaths.
For four counties that experienced more than 10 pregnancy-related deaths over the nine years reported, a mortality ratio was calculated for all of these years, per 100,000 live births. Montgomery had the highest rate in the state at 19.7; the state rate is 14.7.
Cuyahoga (Cleveland): 17.6
Franklin (Columbus): 16.2
Hamilton (Cincinnati): 14.0
Montgomery (Dayton): 19.7
Across the state, for pregnancy-related deaths in 2012 through 2016, ODH found that for more than half of these women, their deaths were preventable. Just less than half of pregnancy-associated deaths were found to be preventable. These numbers speak to the urgency of need for intervention and the positive outcomes that are possible.
Additional biannual data is now anticipated to track pregnancy-associated and pregnancy-related deaths, to raise awareness among communities regarding factors that influence these tragic outcomes and to intervene with systems that serve pregnant and postpartum Ohio women.
| Ohio Pregnancy-Associated Deaths, Pregnancy-Associated Mortality Rate and Pregnancy-Related Deaths by County, 2008-16 | |||
|---|---|---|---|
| County of Residence | Pregnancy-Associated (Number) | Pregnancy-Associated Mortality Rate (per 100,00 live births | Pregnancy-Related (Number) |
| Adams County | 0 | * | 0 |
| Allen County | 6 | * | 1 |
| Ashland County | 2 | * | 1 |
| Ashtabula County | 3 | * | 0 |
| Athens County | 6 | * | 2 |
| Auglaize County | 2 | * | 0 |
| Belmont County | 1 | * | 0 |
| Brown County | 3 | * | 0 |
| Butler County | 24 | 57.5 | 6 |
| Carroll County | 1 | * | 1 |
| Champaign County | 1 | * | 1 |
| Clark County | 13 | **88.3 | 3 |
| Clermont County | 7 | * | 3 |
| Clinton County | 7 | * | 1 |
| Columbia County | 7 | * | 3 |
| Coshocton County | 3 | * | 1 |
| Crawford County | 0 | * | 0 |
| Cuyahoga County | 65 | 47.7 | 24 |
| Drake County | 5 | * | 3 |
| Defiance County | 1 | * | 0 |
| Delaware County | 9 | * | 8 |
| Erie County | 2 | * | 0 |
| Fairfield County | 7 | * | 2 |
| Fayette County | 3 | * | 0 |
| Franklin County | 68 | 40.8 | 27 |
| Fulton County | 5 | * | 1 |
| Gallia County | 0 | * | 0 |
| Geauga County | 2 | * | 0 |
| Greene County | 3 | * | 1 |
| Guernsey County | 4 | * | 0 |
| Hamilton County | 43 | 43.2 | 14 |
| Hancock County | 2 | * | 1 |
| Hardin County | 3 | * | 1 |
| Harrison County | 0 | * | 0 |
| Henry County | 0 | * | 0 |
| Highland County | 5 | * | 1 |
| Hocking County | 0 | * | 0 |
| Holmes County | 2 | * | 1 |
| Huron County | 3 | * | 0 |
| Jackson County | 2 | * | 0 |
| Jefferson County | 5 | * | 1 |
| Knox County | 6 | * | 1 |
| Lake County | 6 | * | 1 |
| Lawrence County | 2 | * | 1 |
| Licking County | 8 | * | 4 |
| Logan County | 5 | * | 1 |
| Lorain County | 16 | **52.0 | 6 |
| Lucas County | 24 | 46.2 | 8 |
| Madison County | 1 | * | 0 |
| Mahoning County | 17 | *77.7 | 4 |
| Marion County | 5 | * | 0 |
| Medina County | 2 | * | 0 |
| Meigs County | 2 | * | 0 |
| Mercer County | 2 | * | 0 |
| Miami County | 3 | * | 1 |
| Monroe County | 1 | * | 0 |
| Montgomery County | 48 | 78.7 | 12 |
| Morgan County | 4 | * | 1 |
| Morrow County | 2 | * | 2 |
| Muskingum County | 8 | * | 4 |
| Noble County | 0 | * | 0 |
| Ottawa County | 0 | * | 0 |
| Paulding County | 0 | * | 0 |
| Perry County | 1 | * | 0 |
| Pickaway County | 2 | * | 1 |
| Pike County | 7 | * | 1 |
| Portage County | 7 | * | 1 |
| Preble County | 1 | * | 0 |
| Putnam County | 3 | * | 0 |
| Richland County | 3 | * | 2 |
| Ross County | 7 | * | 0 |
| Sandusky County | 3 | * | 0 |
| Scioto County | 5 | * | 1 |
| Seneca County | 3 | * | 0 |
| Shelby County | 1 | * | 1 |
| Stark County | 15 | **39.6 | 5 |
| Summit County | 29 | 52.4 | 8 |
| Trumbull County | 15 | **77.6 | 5 |
| Tuscarawas County | 2 | * | 1 |
| Union County | 0 | * | 0 |
| Van Wert County | 0 | * | 0 |
| Vinton County | 2 | * | 0 |
| Warren County | 1 | * | 1 |
| Washington County | 2 | * | 1 |
| Wayne County | 6 | * | 2 |
| Williams County | 3 | * | 1 |
| Wood County | 4 | * | 1 |
| Wyandot County | 1 | * | 0 |
| OHIO*** | 610 | 48.2 | 186 |
| Source: Ohio Department of Health. A Report on Pregnancy-Associated Deaths in Ohio 2008-2016. 2019. * Ratios based on fewer than 10 deaths are considered unreliable and not reported. ** Ratios based on fewer than 20 deaths should be interpreted with caution. *** The total for Ohio includes 124 deaths where the last county of residence was unknown. |
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[1] Maternal mortality includes the death of a women during pregnancy, or the year following a pregnancy. Included are deaths caused by or related to the pregnancy or delivery and those that are related temporally but not caused by the pregnancy.