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OUR MOMS, OUR BABIES

The state of maternal and infant health in Cincinnati and Hamilton County

OUR CITY FACES AN INFANT DEATH CRISIS.

Over the past five years, 543 babies died in Hamilton County. Thats 543 kids who never had a birthday party. 543 children who never went to school. 543 people who never had a chance to grow up. This puts Cincinnati at twice the national average, and gives Hamilton County the tragic distinction of being among the five worst urban communities in our country. This is unacceptable.

Infant deaths per 1,000 births


Cincinnati Hamilton County United States

What does our infant mortality show us?


Poor health. A communitys infant mortality rate is often seen as a canary in the coal mine. If our most vulnerable citizens are dying at an alarming rate, that indicates poor overall health for the rest of us. Inequality. The prematurity rate in Hamilton County is 69% higher among African Americans. Ohios African American infants die at more than twice the rate of white infants. That holds true even when factoring in socioeconomic status.
Source: Ohio Dept of Health

12.4 9.9 6.1


Sources: Ohio Department of Health, Hamilton County Public Health, Centers for Disease Control and Prevention. Data for Cincinnati and Hamilton County is the 2009-2013 infant mortality rate. Data for United States is for the year 2011.

Expense. Premature babies medical costs average more than 12 times those of a full term baby. That means that our community spends more than $80 million a year on preemie care. We collectively bear that cost through increased insurance and Medicaid premiums.
Source: March of Dimes

Helping our babies begins by helping our mothers.


Premature birth is the root of most infant health problems. Solving this crisis begins with helping our mothers carry their babies to full term. And since over half of local pregnancies are unplanned, improving a mothers health during pregnancy relies upon improving womens health in general.

We need better womens health.


Womens Health

We need better pregnancy health.


Pregnancy

We need better infant health.


Year One

368
more likely to have an infant death Women who enter pregancy obese are

Women with pregnancies spaced less than 18 months apart are

Women in Hamilton County struggle with higher rates of obesity, STDs, drug abuse, poverty and stress than state and national averages. This means theyre more likely to be at risk before pregnancy even begins.

Pregnant women in our community are more likely to deal with hypertension, gestational diabetes and preterm birth than their peers.

In their first year of life, babies in Hamilton County die in their sleep at three times the national rate. Their mothers are less likely to breastfeed, less likely to receive a postpartum check-up and more likely to suffer from postpartum depression.

48
more likely to have an infant death

%
Moms who smoke at any point during their pregnancies are

70%
of 2013 Hamilton County infant deaths were impacted by preterm birth

more likely to have an infant death

44

%
Sources: Hamilton County Public Health, Maternal and Infant Health Assessment Chartbook 2007-2009; Cincinnati Health Department, Fetal and Infant Mortality Review

Were three steps from making a difference.

Cradle Cincinnati is a collective of city leaders united against infant mortality. We launched in 2013 with a bold vision: that every child born in Hamilton County will live to see his or her first birthday. Infant mortality is a complex issue, but its solvable. We believe our numbers can change. And when they do, our city will change. Here are three ways we can save lives. We call them the 3 Ss.

Spacing
Enough time between pregnancies. Preterm birth is more likely if Mom gets pregnant less than 18 months after giving birth to her previous child.

33%
of 2013 Hamilton County infant deaths were impacted by inadequately spaced pregnancies

Smoking
No tobacco while pregnant. Smoking increases the likelihood of premature birth.

15%
of 2013 Hamilton County infant deaths were impacted by smoking while pregnant

Sleep
Safer sleep practices. Babies sleep safest when they sleep alone, on their backs and in a crib.

16%
of 2013 Hamilton County infant deaths were impacted by unsafe sleep

Cradle Cincinnati is a partnership between: Hamilton County, The City of Cincinnati, Cincinnati Childrens Hospital Medical Center, UC Health, Mercy Health, TriHealth, The Christ Hospital, The United Way of Greater Cincinnati, The Greater Cincinnati Foundation, The Center for Closing the Health Gap, Interact for Health, The UC College of Nursing, The Cincinnati Medical Association, The Greater Cincinnati Health Council, Deskey, The Cincinnati Health Department, Hamilton County Public Health

Sources: Cincinnati Health Department, Fetal and Infant Mortality Review

What happens now?


We work together. Our infant death crisis can only be solved by a city unitedby individuals, neighborhoods and organizations all running to the aid of our most vulnerable citizens. Our mothers need to know that they and their babies are loved, and see proof through overwhelming support in their own communities. Our medical community needs to work cooperatively toward a better system for women. And we all must be able to communicate simple, actionable steps to improve the outcomes of our own friends and family.

How can I help?


Your biggest contribution to this fight is to either partner or promote.

Partner
Join the other organizations and communities in our citywide fight against infant mortality. Contact us at info@cradlecincinnati.org to learn more.

Promote
Simply share our story with a friend. Let them know about the state of our community when it comes to infant mortality. Share the 3 Ssthree simple but impactful ways to change our city.

Supporting Data
Womens Health
COMPARISON

Pregnancy Health
COMPARISON

Infant Health
COMPARISON

2012 IMPACT

2012 IMPACT

Pre-pregnancy Body Mass Index


among women who had live births Underweight (BMI < 18.5) Obese (BMI 30) 4.5 24.0 4.4 23.3 4.4 20.5 4.0 27.7 3.7 31.8 4.7 20.5

Preterm Birth Rate

Breastfeeding Rates
upon hospital discharge 11.7 2.6 2.0 (US) 0.3 11.3 2.5 14.7 5.2 18.6 5.2 11.0 1.9

4 30

<37 Weeks <32 Weeks

13.7 3.1

66 63

66.5

68.6

75.9

59.8

52.6

72.7

Postpartum Checkup
0.1 0.7 0.9 0.3

2012 IMPACT

AFRICAN AMERICAN

AFRICAN AMERICAN

AFRICAN AMERICAN

BEST 5 ZIP CODES

WORST 5 ZIP CODES

BEST 5 ZIP CODES

WORST 5 ZIP CODES

BEST 5 ZIP CODES

WORST 5 ZIP CODES

LOCAL

LOCAL

LOCAL

WHITE

WHITE

WHITE

Todd Portune Hamilton County Commissioner; Co-chair, Cradle Cincinnati Wendell Young Cincinnati City Councilmember; Co-chair, Cradle Cincinnati Ryan Adcock Executive Director, Cradle Cincinnati

Sexually Transmitted Infection Rates


among women who had live births Syphilis Gonorrhea Chlamydia 0.5 1.6 5.6 0.1 0.5 2.6 0.1 0.4 3.9 0.8 3.7 9.7 1.2 3.8 11.2 0.1 0.4 2.5

<23 Weeks

0.5

37

among women who had live births 86.7 90.1 -

1 3 13

Late or No Prenatal Care


among women who had live births Accessed care in third trimester No care 3.1 15.2 3.5 7.5 1.9 12.5 3.9 15.5 4.7 17.2 1.7 13.9

Postpartum Depression

4 12

among women who had live births 14.8 12.8 -

Brought to you by:

Unintentional Pregnancy
among women who had live births 50.2 46.9 -

Maternal Smoking Rates

Unsafe Sleep Deaths


2010-2011 12.9 15.1 12.8 17.9

15.0

17.7

15

1.58/ 0.55/ 1,000 1,000

2.7/ 0.9/ 1,000 1,000

16

Inadequately Spaced Pregnancy


Less than 18 months between pregnancies 12.7 11.8 7.6 15.1 17.1 10.1

Previous Preterm Births

28

among women with previous births 6.1 4.1 3.8 9.6 9.3 4.6

11
In partnership with:

Always or usually get social/emotional support


among all adults 79.0 81.0 (OH) (MA) 64.3 84.1

Chronic Illness or Co-Morbid Condition

among women who had live births Gestational Diabetes Hypertension 7.4 11.1 6.2 8.3 7.3 10.3 6.6 16.4 6.8 15.7 7.1 9.0

8 14
Data Sources 2011 Ohio Department of Health Vital Statistics; 2010-2012 Pregnancy Risk Assessment Monitoring System (PRAMS); 2005-2010 Behavioral Risk Factor Surveillance System (BRFSS); 2011 Ohio Department of Health Vital Statistics; Fetal and Infant Mortality Review; 2007-2011 American Community Survey; 2012 March of Dimes report card

Substance Abuse Rates


among all adults Smoking Excessive Drinking Illegal Drugs 19.0 (US) 20.0 18.0 8.5 8.8 (OH) (US) 20.0 -

22 -

Individuals with Stable Housing


among the entire population Renters Vacancy Rate >1 Occupants Per Room Moved in the Past Year 35.5 11.5 1.5 16.4 32.2 (US) 11.4 (US) 3.1 14.8 28.0 7.5 0.6 12.8 51.1 15.6 1.6 24.9 -

Terms LOCAL: Hamilton County unless otherwise indicated. COMPARISON: State of Ohio unless otherwise indicated. BEST 5 ZIP CODES: How the neighborhoods with the best 2007-2010 infant mortality rates fared in this category (45230, 45251, 45209, 45218, 45226). WORST 5 ZIP CODES: How the neighborhoods with the worst 2007-2010 infant mortality rates fared in this category (45219, 45203, 45237, 45229, 45224). 2012 IMPACT: % of infant deaths in 2012 that had this associated factor. All numbers are percentages, unless otherwise indicated. African American and White data is shown to reveal inequality.

Thanks to: Eric Hall, PhD; Data Director, Cradle Cincinnati Jennifer Mooney, PhD, MS; Cincinnati Health Department David Carlson, MPH; Hamilton County Public Health Will Scott; Cradle Cincinnati Maggie Hague; Cincinnati Health Department David White; Project Coordinator, Cradle Cincinnati Design: Craig Dockery Photography: Jonathan Willis Creative Assistance: Jennie Chacon

Cradle Cincinnati: a collective of city leaders with the bold vision that every child born in Hamilton County will live to see his or her first birthday.

Three ways to save lives

Spacing
Enough time between pregnancies. Preterm birth is more likely if Mom gets pregnant less than 18 months after giving birth to her previous child.

Smoking
No tobacco while pregnant. Smoking increases the likelihood of premature birth.

Safer sleep practices. Babies sleep safest when they sleep alone, on their backs and in a crib.

Sleep

cradlecincinnati.org

513-558-7013

info@cradlecincinnati.org