Cincinnati babies don't get the same chance at seeing their first birthday as do infants in other states across the country, and area health professionals believe it's time to become more proactive about it.
On Wednesday, Noble Maseru, Cincinnati health commissioner, and Dr. Elizabeth Kelly, a maternal-infant health specialist at University Hospital, presented statistics to City Council in support of expanding city-wide efforts to reduce infant mortality rates (IMRs) and reconsider infant care and public health strategies.
Infant mortality rates are typically measured by the number of deaths of babies under
one year of age per 1,000 live births. Statistics show that the overall
IMR rate in counties across Cincinnati from 2006-2010 was 13.3. In 2010, the U.S. infant mortality rate was 6.8 — just a little more than half of Cincinnati's alarming statistic.
According to the City of Cincinnati Health Department, infant mortality rates are currently the highest in the 45202 zip code; the rate between 2007-2009 was 24.2.
Other Hamilton County zip codes with high IMRs include 45203 (20.1), 45229 (17.5), 45214 (19.2) and others. Zip codes with the lowest rates included 45218 (0), 45226 (0), 45248 (3.7) and others. Click here to access a complete map with data for all Cincinnati zip codes.
Pinpointing causes for discrepancies in IMRs is difficult, but the following are common causes of death in infants under one year old, according to the Ohio Department of Health:
• Prematurity/low birth weight (prematurity is the No. 1 cause of infant death)
• Congenital anomalies
• Sudden infant death syndromeThese abnormalities are distributed differently across demographics, especially varying across race brackets.
According to Maseru, the key to reducing rates locally is uniting area hospitals in an effort to provide a comprehensive continuum of care, beginning with monitoring prenatal development and spanning across the delivery experience into post-partum care. That continuum should encompass post-partum home visits, psycho-social counseling and education on nutritional support, domestic violence, etc., especially focusing on families in "high-risk" zip codes.
For the past several years, the Cincinnati Health Department has teamed up with University Hospital for the Maternal/Infant Health Improvement Project, a partnership uses that continuum of care to meld public health strategies and medical expertise to reduce IMR rates in University Hospital, and according to the data presented to the Rules and Governance Committee on Wednesday, the system is working.
Maseru says that over the five-year span from 2006-2010, the Health Department/University Hospital partnership yielded a 10.6 IMR rate, which marks about a 20 percent difference from Cincinnati's overall rate.
The next effort, Maseru says, will be expanding that partnership into a network that applies the strategies the Improvement Project has been using to other local area hospitals, such as Good Samaritan and Christ Hospital, who account for 85 percent of Cincinnati deliveries annually.
"It's all about achieving health equity," says Maseru. He hopes a successful parternship could bring IMR rates across every Cincinnati zip code down to single digits by 2014.