Eliminating the Racial Disparity in Infant Mortality

A Black infant is being held up in an adult's arms. The infant is smiling.

By Christine Sander, MHA
Director of Infant Wellness Initiatives, Nationwide Children’s Hospital
Director, Ohio Better Birth Outcomes Collaborative

By 2013, Columbus had one of the highest infant mortality rates among the United States’ largest cities, and Black babies were 2.5 times more likely to die than white babies. Our local health systems, our local governments, our public health agencies – we all understood this crisis had to be addressed.

So in 2014, many of us came together to form CelebrateOne, a county-wide initiative to do just that. It’s named after our goal of helping every child celebrate a first birthday.

Columbus Mayor Andrew J. Ginther (who was then president of the City Council) was an early champion and helped show business leaders how crucial this issue was to them and their employees. Columbus Public Health helped drive the overall effort. The area’s four health systems – Nationwide Children’s Hospital, The Ohio State University Wexner Medical Center, OhioHealth and Mount Carmel – also came together with the area’s Federally Qualified Health Centers to form the affiliated Ohio Better Birth Outcomes Collaborative, which I am proud to lead.

CelebrateOne Logo

CelebrateOne has rolled out a new strategic plan that puts a laser-like focus on reducing the racial disparity in infant mortality, while building and extending our efforts that have worked to reduce the overall rate.

We are encouraged by the success we’ve seen thus far through a wide range of interventions, from safe sleep education and expansion of maternal home visiting programs to tobacco cessation programs, other perinatal supports, and greater health care access. In 2014, there were 8.4 infant deaths per 1,000 live births. By 2020, it was 6.7 per 1,000.

That’s dozens of lives saved over that time in Franklin County.

But while the rate has improved for all demographics, the disparity between Black and white infant mortality rates actually has widened. For white children, the rate was 5.7 in 2014 and 4.1 in 2020. For Black children, the rate was a shocking 14.9 in 2014. In 2020, it was 11.4.

Black infants are now nearly 3x more likely to die than white infants. So we must do more.

This summer, CelebrateOne has rolled out a new strategic plan that puts a laser-like focus on reducing the racial disparity in infant mortality, while building and extending our efforts that have worked to reduce the overall rate. One of its most important elements is to center the lived experiences of women of color who face racism and disparity.

We have six main strategies:

  • Target and address structural and interpersonal racism as fundamental drivers of infant mortality
  • Address the social determinants of health across the life course to advance maternal and child health
  • Advance policies that prevent poor birth outcomes and promote women's health and wellbeing rights
  • Improve provision of reproductive health care from preconception through one year of age
  • Design and implement a connected and consistent care experience for mothers and babies
  • Accelerate innovation, progress, and accountability for health equity

Ohio Better Birth Outcomes – the collaborative of health care providers – has a number of specific tactics to support those overall goals, including expanding home visitation programs for expectant and new mothers, implementing universal maternal risk screening and connection to services, boosting reproductive health planning in primary care and educating providers about racial bias, stigma, and discrimination in reproductive health care.

Nationwide Children’s shares those same tactics, but we bring unique abilities to help address a mother’s social determinants of health (housing, education, employment) through our Healthy Neighborhoods Healthy Families initiative, to educate and care for adolescents in our school-based health programs, and to focus on teen behavioral health.

Nationwide Children’s is so committed to this work that we have made infant mortality one of the key measures in our comprehensive Pediatric Vital Signs initiative, which works to measure and improve the health of all children in our area. If we want to have a real impact, we must start at the beginning of their lives.

It takes a collaborative effort throughout the community to reduce – and someday eliminate – the racial disparity in infant mortality. CelebrateOne, Ohio Better Birth Outcomes and Nationwide Children’s have come together with big goals, and a lot of work ahead of us. We know other communities across the country are also working to end infant mortality. Share your strategies and programs through our Twitter channel @Collab4KCH to keep the national momentum going.