Reducing Toxic Lead and Tobacco Smoke Exposures

Every baby deserves to celebrate a first birthday. But in Cleveland, Ohio, too many babies did not get that chance. That is until city and county system leaders established First Year Cleveland (FYC) on December 30, 2015. And although our community has seen a 23% decrease in infant deaths from 2015 to 2019, we are collectively working together to accelerate our community’s efforts to further decrease infant deaths and eliminate infant death racial disparities by 2025.

Of the 13,937 babies born in Cuyahoga County in 2019, 120 didn’t celebrate a first birthday. This number is staggering, but the racial disparities within them are even worse. It is why FYC is so proud that we partnered with local government officials and administrations, YWCA Greater Cleveland, Urban League of Greater Cleveland, Cleveland NAACP, United Way of Greater Cleveland, and Birthing Beautiful Communities to declare racism a public health crisis.

Our leaders of housing, education, employment, health care, and criminal justice systems, systems which serve our Black expecting parents and new parents, are being proactive in leading new equity solutions to address the centuries of structural racism that produced the centuries of inequality.

For example, a Black woman who is highly educated and compliant with prenatal care is more likely to have her infant die than a White woman with no high school degree and poor to no prenatal care. In 2018, in the City of Cleveland, Black infant deaths were extremely alarming, with an infant mortality rate (IMR) of 17.51, compared to a White IMR of 3.03. The infant mortality rate is the number of infant deaths per 1,000 live births and is a key indicator of the overall health of a region.

In other words, for every white baby that died before their first birthday, nearly six Black babies died.

On December 30, 2015, community leaders established FYC to reduce all infant deaths, to address the racial inequalities and injustices that Black expectant and new parents face, and to help ensure that all babies get to celebrate their first birthdays as healthy, happy little ones. Today, this collaborative effort brings together parents and expectant parents, community leaders, philanthropic organizations, government and business entities, health care providers, educational institutions, nonprofits and the faith-based community to achieve social change necessary for healthier birth outcomes.

As part of our initiative to ensure that all babies have the best shot at health, FYC has partnered with Bright Cities to help reduce exposures to lead and tobacco smoke for expectant mothers and babies living in Cuyahoga County.

Reducing exposures to lead and supporting use of programs to reduce tobacco use have the potential to impact premature birth and infant mortality rates in Cuyahoga County and throughout the state. And, both lead and tobacco smoke are toxic environmental chemicals linked to neurodevelopmental disorders such as autism spectrum disorder, attention deficits, hyperactivity, intellectual disability and learning disorders.

FYC is focusing on three actions to help reduce these exposures — because 2020 has reconfirmed and accelerated our commitment to continue our laser focus on equity and health.

• As part of FYC’s 2021-2023 equity strategic planning process, a strategic planning Design Team (including partners from health care, social services, policy makers, community organizations, advocates, and parents) received examples of recent studies on the impact of neurotoxic chemicals on infant mortality. The Design Team is providing regular updates on its progress, via First Year Cleveland’s website, and will be delivering its final recommendations to the community in January 2021.
  
  
• We continue to target smoking cessation among expectant parents and in households with newborn infants. Our Safe Sleep Action Team has provided education to more than 17,000 “Safe Sleep Heroes” who are engaged with the community to eliminate exposure to tobacco smoke in homes of expectant and new parents, and reduce preventable sleep-related infant deaths.
  
  
• One of our key practices is working with expectant mothers using a group prenatal care model. The CenteringPregnancy® program brings expectant moms into groups for prenatal care, based on estimated dates of delivery. In this model, standard prenatal risk assessment occurs within the group setting and time is provided for women to talk and share with one another.

We are working with the Centering® Healthcare Institute to consider adding content to their formal CenteringPregnancy® curriculum on reducing exposure to lead-based paint and unsafe products in the home environment. We will then pilot this revised CenteringPregnancy® curriculum in Cuyahoga County. Finally, we’ll determine feasibility with the Centering® Healthcare Institute on sharing revised curriculum and best practices with other Bright Cities.

“Cleveland has historically had a high number of children with elevated blood lead levels. Because lead poisoning is detrimental to a child’s health and development, MomsFirst provides parent education on lead poisoning prevention to ensure our families are educated about the risks and can reduce or eliminate their child’s exposure. Our goal is to ensure every child is born into a healthy environment and the educational materials provided by First Year Cleveland are another tool we can use in this effort,” said Lisa Matthews, MomsFirst Project Director.