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What Impact Does
Race and Racism Have on Infant Mortality?
Infant Mortality (IM)
refers to the death of an infant before their first
birthday. The Infant Mortality Rate (IMR) is the number of
infant deaths that occur for every 1,000 live births. The
IMR is an important measure of how we care for our women,
children, families and the overall health of a society.
There is racial disparity between black infant deaths and
white infant deaths in Ohio and Lucas County.
Infant Mortality Rates in
Ohio are among the worst in the nation, while the rest of
the nation IM has improved, Ohio has gotten worse.
According to the Ohio Department of Health in 2015 the
Infant Mortality overall rate for Ohio was 7.2 deaths per
1,000 live births, for Lucas County it was 6.3. In Lucas
County for white infants it was 1.6 deaths per 1,000 live
births and for African-American infants it was 16.8 infant
deaths per 1,000 live births Why This Disparity?
One of the best-studied
and most troubling examples of racial disparities in health
outcomes is the difference in rates at which our babies
survive the first year of life. We generally discuss the
causes of infant mortality in clinical terms, explaining
that the most common causes are Preterm Birth, Congenital
Anomalies and Sudden Infant Death Syndrome. Where groups,
communities, cities, states, or countries maintain low
infant mortality rates the likelihood is fairly good that
the quality of life for that group or geographical area is
good. The converse is also true. Where the IMR is high the
quality of life for that group or geographical area is
likely fairly poor.
This is critically important to understand. The infant
mortality rates can tell us something about the health of a
community and the quality of life experienced by its
residents. In this way, the IMR is a social indicator, and
in general finds correlation with variables like; income
status, educational attainment, neighborhood quality,
housing stability, food security, access to care,
relationship cohesiveness, racism, sexism, and others.
Individually, none of these can account for high rates of
infant mortality, but together, the devastation of their
collective force cannot be denied.
“When a flower doesn’t bloom, you fix
the environment in which it grows, not the flower”
(Alexander Den Heijer)
Poverty, including decreased access to health care,
diminished access to adequate housing, lack of sufficient
nutrition, and increased exposure to environmental
insults—are important direct correlates of infant mortality
as well as risk factors for many of the key causes of infant
death including preterm delivery, low birthweight, infant
homicide, and Sudden Infant Death Syndrome (SIDS).
Moreover, the underlying causes of disparities in infant
health and survival must be specifically tackled.
Improved access to health care
services is necessary but not sufficient for closing the
gap. Social determinants of health—such as income
inequality, unequal treatment, and institutionalized
racism—are associated with adverse birth outcomes and infant
mortality. Changing the underlying
social and economic factors that drive disparities must be a
top priority in our national strategy for improving birth
outcomes and reducing infant mortality.
Preterm or delivering
prior to 37 weeks gestation and low birth weight are the
biggest contributors to infant deaths. African-American
women are far more likely to have a baby born early.
Researchers say the reason for this remains unclear. It
cannot be fully explained by inadequate prenatal or medical
care or genetics, income or by education. The research in
Ohio shows that an African-American woman with 16 or more
years of education have poorer birth outcomes than a white
woman with less than a high school education.
A growing body of evidence
(research) has suggested that chronic stress related to
racism may play a key role in influencing birth outcomes for
African-American women. The stress can affect
African-American women regardless of their economic status,
even if they do everything right during their pregnancy.
Discrimination is a documented source of harmful stress.
Birth weight distribution
of African-born blacks are more closely related to US-born
whites than to US-born blacks.
An indicator of one’s
health can be linked to the neighborhood that person lives
in. Where a person is born, lives, grows, works, age and
the Social Determinates of Health (SDOH. These factors
influence the health of a person more than clinical care and
behavioral lifestyles. The following zip codes show the
highest racial disparities with the worst birth outcomes
they are 43604, 43605, 43607 and 43608
Michael C. Lu, MD, MPH,
Associate Administrator Maternal and Child Health, Health
Resources and Services Administration, U.S. Department of
Health and Human Services has done extensive research on
Racial-Ethnic Disparities in Birth Outcomes. To make impact
in reducing this racial disparity, he recommends taking a
“Life-Course Perspective”. A way of looking at life not as
disconnected stages but as an integrated continuum. He
states “You can’t cure a life time of ills in nine months”
You must not only look at the child-bearing age woman’s life
experiences but that of her mother’s life experience as
well.
Toledo-Lucas County’s Ohio
Equity Institute (OEI)’s Getting to 1 is a community-driven
effort working towards elimination of the disparities and
reducing Infant Mortality in Lucas County The participants
are community serving agencies and community members that
come from multiple sectors such as, faith based, health
care, education , elected officials, hospitals, community
members and those affected by this disparity. Everyone’s
voice is needed at this table to eliminate this disparity.
OEI intervention in the community are ongoing, from
preconception and inter-conception education, safe sleep
education, referral into the community for social services
and addressing racism as a SDOH.
Eliminating this Disparity requires all hands on deck!
The Ohio Equity Institute
(OEI), welcomes the community to become a part of the team
because we want community collaboration. The meetings are
held every second Tuesday of the month. The next meeting
will be Tuesday October 10 at 9 a.m. at the Kent Branch
Library. ALL ARE WELCOME TO ATTEND!
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