Cuyahoga County Infant Mortality Dropped To Lowest Rate In 30 Years In 2020

Preliminary data shows Cuyahoga County is seeing significant improvements in its infant mortality rate after decades of concerning numbers.

The overall infant mortality rate dropped to 7.57 deaths per 1,000 live births in 2020 – the lowest level reported in 30 years, said Richard Stacklin, data analyst at the Cuyahoga County Board of Health.

Of the more than 13,000 babies born in the county in 2020, 100 did not survive through their first year of life, Stacklin said.

“The 100 deaths… is significantly lower than what we’ve seen in previous years,” he said.

Cuyahoga County’s pre-term birth rate also improved, he said. The county averages about 50 to 60 infants per year who are born before 22 weeks of gestation, but in 2020, it reported just 33, he said.

“One of the big reasons infant mortality is down this year is the significant decrease in pre-term babies born,” Stacklin said.

However, racial disparities continued to persist across all data points, Stacklin said.

Of the 100 infants that died, 73 were Black, he said, and Black babies accounted for more than 80 percent of the county’s pre-term births.

The Black infant mortality rate for 2020 was 14.6 deaths per 1,000 live births, about twice the overall rate, Stacklin said, and dramatically higher than the rates for both white and Hispanic babies, which were 3.5 and 2.0, respectively.

However, the Black infant mortality rate is consistently improving, he said.

“Even though there’s still a large gap… 14.6 was the lowest in the last five years,” Stacklin added.

Numbers Rising As Pandemic Slows

Although the county’s overall infant mortality rate reached an historic low in 2020, infant deaths seem to be ticking back up again in 2021, he said.

The rate through May 2021 is 8.9 deaths per 1,000 live births, compared to 7.8 in May 2020, Stacklin said.

The significant drop in deaths last year and subsequent uptick this year could be tied to the COVID-19 pandemic.

“For some reason, it seemed like the pandemic was a positive effect for infant mortality, and heading back to real life, we’re trending back, unfortunately,” Stacklin said.

One hypothesis, he said, is that mothers, particularly those who are African American, may have stayed home more often during the pandemic and experienced less stress. Black moms may also be experiencing racism or prejudice more frequently in their daily lives now, which can cause added stress during pregnancy, he said.

Stacklin presented the preliminary data Tuesday during the quarterly meeting of the Community Action Council for First Year Cleveland, a coalition of local organizations focused on decreasing the county’s infant mortality rate.

Dr. Jennifer Bailit, former co-chair of the council and obstetrician at MetroHealth System, said more research is needed before health officials can draw any conclusions.

“It could be one or two multiple pregnancies that caused the difference in rates, and it may just be random chance, too,” she said. “A couple sets of twins or triplets could do this.”

The council also discussed next steps to try to continue reducing infant mortality in the county, particularly targeting systemic racism.

First Year Cleveland is currently in transition and will soon begin searching for a new executive director. Katrice Cain, who previously served as the organization’s Racial Disparities and Health Equity Program director, became interim director after Bernadette Kerrigan left at the beginning of June.

“Regardless of the changes that are happening, improving maternal and infant health outcomes, particularly for Black moms and babies, will always remain at the forefront of our work,” Cain said Tuesday.

First Year Cleveland officials plan to continue working with both at-risk moms as well as fathers, educating them on healthy behaviors for infants such as safe sleep.

They are also advocating to preserve and increase state funding for initiatives aimed at improving infant and maternal outcomes, such as home visits and housing programs, as well as infant mortality grants from the state’s Office of Minority Health, officials said.  

And council members are collaborating with partners in other states with similarly high rates of infant mortality and racial disparities, such as Michigan. The Midwest has the highest Black infant mortality rates in the country, according to data from the U.S. Department of Health and Human Services.

More specific courses of action will be released as the executive committee moves forward in its process of hiring a new executive director, including the development of a new strategic plan, Cain said.