By: Erin Ryan, Director, Center for Maternal & Young Child Health at Groundwork Ohio
With the new year, there comes a sense of renewal, recommitment, and opportunity. Groundwork Ohio has remained steadfast in our vision of making Ohio the best place to be a young child, and as we transition to a new year, we are in a time of reflection to determine how we can continue to uphold this mission. One policy area that has continued to remain a priority has been developing healthy beginnings for children, specifically addressing the abysmal rates of maternal and infant mortality in our state.
Over recent years, there has been progress in reducing the overall infant mortality rate. Unfortunately, when you dig deeper into the data, there remain troubling racial disparities in outcomes. In fact, the infant mortality rate for non-Hispanic Black infants is still three times higher than that of non-Hispanic white infants. Despite the increased attention and focus on the issue of inequity within infant health outcomes, the racial disparity ratio in infant mortality rates has worsened over the last decade in Ohio.
We cannot fully address the racial disparities in infant mortality without acknowledging and tackling racism, particularly systemic racism within the health care system, as a root cause of poor health outcomes. By having an intentional focus on engaging and centering Black women, families, and communities in this work, we can build solutions that reflect their lived experiences, address unique barriers they face, and provide a distinct response to their needs.
In recognition of the alarming disparities in maternal and infant health outcomes facing Black mothers and infants, Governor DeWine established in late 2020 the Ohio Eliminating Racial Disparities in Infant Mortality Task Force, a group comprised of local, state, and national leaders who would come together to establish a path forward to addressing the crisis. It was formed to provide Governor DeWine with actionable recommendations on how to eliminate the racial disparity in the infant mortality rate with an intentional commitment to listen to Black women, families, and communities throughout the process to ensure that recommendations were grounded in reality. In addition to the thoughtful leadership engaged to support the aims of the Task Force, the Ohio Department of Health engaged Groundwork Ohio’s Center for Family Voice to support and facilitate listening sessions across the state of Ohio.
Groundwork supported more than 30 family listening sessions held in 11 counties across the state through partnerships with local community-based organizations and commission members to understand the experiences of Black families and their infants. There were 174 family participants, the majority of whom were Black women, engaged through these sessions and compensated for their time and expertise. With Groundwork serving as the organizing and operational backbone, the listening sessions were hosted by local partners that applied to recruit families and to support the participation of families before, during, and after the sessions. In addition to Groundwork Ohio being represented on the Commission itself with its President & CEO, Shannon Jones, serving as an appointed member, every member of our staff had the privilege of supporting and listening to Black Ohioans sharing their insight, individual and community expertise, and deeply personal experiences. Perhaps most importantly, as listeners and supporters of these facilitated sessions, we can now validate that the words, experiences, feedback, hopes, and hurdles of these experts were foundational in shaping the final report and recommendations of the Task Force.
As we kick off 2023, the culmination of this Task Force’s years of work has resulted in a newly released report of final recommendations for the governor with actionable steps to eliminate disparities that exist in the infant mortality rate. The Task Force outlined that, for these recommendations to be most effective, the following three key factors must be acknowledged and considered by the agencies and individuals responsible for overseeing implementation:
Address Structural Barriers
Focus on Systemic Change
Listen to Black Voices
The report stresses that while there are individual risk factors that determine health outcomes for pregnancies, the disparities persist when accounting for these factors as a result of the underlying drivers of inequities: poverty, racism, discrimination, trauma, violence, and toxic stress. This understanding prompted the Task Force to establish a holistic framework for their recommendations to eliminate racial disparities in infant mortality, rather than just focusing on changes that individuals should make before, during, and after pregnancy. The group’s recommendations were created to focus specifically on the Black population within 11 key counties in the state, falling under the following categories, modeled after the Healthy People 2030 Social Determinants of Health (SDOH) Framework:
Healthcare Access and Quality
Education Access and Quality
Neighborhood Built Environment
Social and Community Context
The full report goes in-depth on the specific recommendations and concepts for action that state and local stakeholders in this work should implement. The Task Force highlights that these action-oriented recommendations are intended to build state and local capacity to address the issue, test small-scale innovative strategies that take on a new approach to drive forward solutions, and build public and professional awareness of the issues related to improving maternal health outcomes before, during, and after pregnancies, especially for Black women.
While the final step of the Governor’s Eliminating Disparities in Infant Mortality Task Force is complete with the release of this final report, the work is far from over. This report provides a pathway to advance concrete change in the lives of Ohio’s babies, pregnant women, and families. Now is the time for a recommitment to the hard work ahead that will not only recognize the inequities that exist in birth outcomes, but move towards truly eliminating the racial disparities in infant mortality rates and building an Ohio that ensures that every child can thrive.